Providence Neurology Clinic Pa
LBN: Providence Neurology Clinic Pa
Providence Neurology Clinic Pa is an health care organization with primary practice located at 220 W Hillside Rd Suite 5 B, Laredo TX 78041-6903. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Clinical Neurophysiology. Allopathic & Osteopathic Physicians / Neurology is the primary health care specialty.
Providence Neurology Clinic Pa can be contacted via phone (956) 717-4074, or through Mukamana, Grace via phone (956) 717-4074.
Contact Information
Primary practice address
220 W Hillside Rd Suite 5 B
Laredo TX 78041-6903
Phone: (956) 717-4074
Fax: (956) 717-4186
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | N3913 | Texas |
| Allopathic & Osteopathic Physicians / Clinical Neurophysiology | 2084N0600X | N3913 | Texas |
Profile Details
| NPI number | 1144555251 |
|---|---|
| LBN Legal business name | Providence Neurology Clinic Pa |
| DBA Doing business as | |
| Authorized official | Mukamana, Grace Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 7th, 2009 |
| Last updated | Jun 21st, 2012 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144555251 | NPPES |
| Texas | MEDICAID | 210191701 |
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