Provider Demographics
NPI:1801377528
Name:TEXAS NEUROLOGY, P.A.
Entity Type:Organization
Organization Name:TEXAS NEUROLOGY, P.A.
Other - Org Name:TEXAS NEUROLOGY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-827-3610
Mailing Address - Street 1:6080 N CENTRAL EXPY STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-5202
Mailing Address - Country:US
Mailing Address - Phone:214-279-0336
Mailing Address - Fax:214-279-0337
Practice Address - Street 1:6080 N CENTRAL EXPY STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-5202
Practice Address - Country:US
Practice Address - Phone:214-279-0336
Practice Address - Fax:214-279-0337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-22
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX321933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy