Provider Demographics
NPI:1508181132
Name:NEUROSAFE, PLLC
Entity Type:Organization
Organization Name:NEUROSAFE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-296-9444
Mailing Address - Street 1:9200 PINECROFT DR
Mailing Address - Street 2:SUITE 280
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3279
Mailing Address - Country:US
Mailing Address - Phone:281-296-9444
Mailing Address - Fax:
Practice Address - Street 1:9200 PINECROFT DR
Practice Address - Street 2:SUITE 280
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3279
Practice Address - Country:US
Practice Address - Phone:281-296-9444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty