Corporate-Industry Medical Group
Clinical Neuropsychologist in Irving, TX. Organization (NPI-2).
NPI number1174731517
StatusActive
Last updated in NPPESApr 25, 2014
Details
- NPI
- 1174731517
- Entity type
- Organization (NPI-2)
- Legal business name
- Corporate-Industry Medical Group
- Organization subpart
- No
- Enumeration date
- May 18, 2007
- Last updated
- Apr 25, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | – | – | Yes |
| 208100000X | Physical Medicine & Rehabilitation | – | – | |
| 2083P0500X | Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine | – | – | |
| 208VP0000X | – | – |
Practice location
4425 W Airport FwySuite 305
Irving, TX 75062-5832
Phone 972-570-8200 · Fax 972-570-8933
Mailing address
4425 W Airport FwySuite 305
Irving, TX 75062-5832
Phone 972-570-8200 · Fax 972-570-8933
Authorized official
George F Heath
Ceo
9725708200
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