Provider Demographics
NPI:1013154095
Name:HAROLD B CHILDS III
Entity Type:Organization
Organization Name:HAROLD B CHILDS III
Other - Org Name:NEUROCONCEPTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHILDS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:210-557-4306
Mailing Address - Street 1:10999 IH 10 W STE 365
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-1349
Mailing Address - Country:US
Mailing Address - Phone:210-344-1855
Mailing Address - Fax:210-344-1846
Practice Address - Street 1:10999 IH-10 WEST
Practice Address - Street 2:SUITE 365
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230
Practice Address - Country:US
Practice Address - Phone:210-344-1855
Practice Address - Fax:210-344-1846
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL CONCEPTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-13
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty