Provider Demographics
NPI:1891308730
Name:THE INSTITUTE OF NEUROPSYCHOLOGICAL HEALTHCARE, PLLC
Entity Type:Organization
Organization Name:THE INSTITUTE OF NEUROPSYCHOLOGICAL HEALTHCARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSARIO NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:682-259-4255
Mailing Address - Street 1:9500 RAY WHITE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-9105
Mailing Address - Country:US
Mailing Address - Phone:787-407-4268
Mailing Address - Fax:833-694-0829
Practice Address - Street 1:9500 RAY WHITE RD STE 200
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-9105
Practice Address - Country:US
Practice Address - Phone:817-745-4567
Practice Address - Fax:833-694-0829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-29
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty