Provider Demographics
NPI:1184784951
Name:NEUROSURGICAL ASSOCIATES OF TEXARKANA
Entity type:Organization
Organization Name:NEUROSURGICAL ASSOCIATES OF TEXARKANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-794-4196
Mailing Address - Street 1:PO BOX 9600
Mailing Address - Street 2:DEPT 09-019
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75505-9600
Mailing Address - Country:US
Mailing Address - Phone:903-794-4196
Mailing Address - Fax:903-792-7408
Practice Address - Street 1:1002 TEXAS BLVD
Practice Address - Street 2:SUITE 406
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-5113
Practice Address - Country:US
Practice Address - Phone:903-794-4196
Practice Address - Fax:903-792-7408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1252174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00DG35OtherINDIGENT HEALTH CARE
91421OtherFIRST PYRAMID LIFE
AR91421OtherBLUE CROSS OF ARKANSAS
TX094806902Medicaid
OK100752110AMedicaid
179117500OtherUS DEPARTMENT OF LABOR
TX00DG35OtherTEXAS BLUE CROSS GP NO#
AR113562002Medicaid
53713OtherCHAMPUS
91421OtherCOLLUM & CARNEY CLINC
TXCP4245OtherRAILROAD MEDICARE
OK100752110AMedicaid
TXCP4245OtherRAILROAD MEDICARE