Provider Demographics
NPI:1821049560
Name:ARLINGTON NEUROLOGY ASSOC
Entity Type:Organization
Organization Name:ARLINGTON NEUROLOGY ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJENDRA
Authorized Official - Middle Name:P
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-274-7593
Mailing Address - Street 1:912 WRIGHT ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4759
Mailing Address - Country:US
Mailing Address - Phone:817-274-7593
Mailing Address - Fax:817-261-4785
Practice Address - Street 1:912 WRIGHT ST
Practice Address - Street 2:SUITE B
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4759
Practice Address - Country:US
Practice Address - Phone:817-274-7593
Practice Address - Fax:817-261-4785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF77612084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0005DUOtherBCBS OF TEXAS
TX1766263-01Medicaid
TXC15869Medicare UPIN
TX0005DUOtherBCBS OF TEXAS