Provider Demographics
NPI:1255813143
Name:NEUROSKILLS INTEGRATED LEARNING AND CONSULTING, PC
Entity type:Organization
Organization Name:NEUROSKILLS INTEGRATED LEARNING AND CONSULTING, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYD
Authorized Official - Prefix:DR
Authorized Official - First Name:MATHIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NGWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-321-7004
Mailing Address - Street 1:1201 N WATSON RD STE 228
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-6248
Mailing Address - Country:US
Mailing Address - Phone:682-321-7004
Mailing Address - Fax:
Practice Address - Street 1:1201 N WATSON RD STE 228
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-6248
Practice Address - Country:US
Practice Address - Phone:682-321-7004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4132003Medicaid