Provider Demographics
NPI: | 1033742762 |
---|---|
Name: | NEURO CARE LLC |
Entity type: | Organization |
Organization Name: | NEURO CARE LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PHYSICIAN |
Authorized Official - Prefix: | |
Authorized Official - First Name: | FARID |
Authorized Official - Middle Name: | UD |
Authorized Official - Last Name: | DIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 469-493-1964 |
Mailing Address - Street 1: | 3600 NORTHSTAR RD STE 140 |
Mailing Address - Street 2: | |
Mailing Address - City: | RICHARDSON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75082-5309 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 469-493-1964 |
Mailing Address - Fax: | 732-756-9138 |
Practice Address - Street 1: | 318 W FM 544 STE B1 |
Practice Address - Street 2: | |
Practice Address - City: | MURPHY |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75094-4652 |
Practice Address - Country: | US |
Practice Address - Phone: | 469-493-1964 |
Practice Address - Fax: | 732-756-9138 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-02-21 |
Last Update Date: | 2023-11-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2084N0402X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology with Special Qualifications in Child Neurology | Group - Multi-Specialty |