Provider Demographics
NPI:1831200906
Name:NEURAL LOGICS, P.A.
Entity type:Organization
Organization Name:NEURAL LOGICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:DUBOIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-346-6969
Mailing Address - Street 1:7307 CREEKBLUFF DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-8203
Mailing Address - Country:US
Mailing Address - Phone:512-346-6969
Mailing Address - Fax:512-346-6942
Practice Address - Street 1:7307 CREEKBLUFF DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-8203
Practice Address - Country:US
Practice Address - Phone:512-346-6969
Practice Address - Fax:512-346-6942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG58942084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB22390Medicare UPIN
TXH66312Medicare UPIN