Total Neurology Of The Gulf Coast, PA
in Lake Jackson, TX. Organization (NPI-2).
NPI number1508007741
StatusActive
Last updated in NPPESFeb 16, 2017
Details
- NPI
- 1508007741
- Entity type
- Organization (NPI-2)
- Legal business name
- Total Neurology Of The Gulf Coast, PA
- Organization subpart
- No
- Enumeration date
- Mar 18, 2009
- Last updated
- Feb 16, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0600X | K7655 | TX | Yes | |
| 2084N0400X | Psychiatry & Neurology, Neurology | K7655 | TX |
Practice location
201 Oak Dr SSuite 201
Lake Jackson, TX 77566-5676
Phone 979-480-0990 · Fax 979-480-0980
Mailing address
201 Oak Dr SSuite 201
Lake Jackson, TX 77566-5676
Phone 979-480-0990 · Fax 979-480-0980
Authorized official
Lyndon F. Barnwell
Owner
9794800990
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