Provider Demographics
NPI:1144387051
Name:CENTER FOR NEUROPSYCHOLOGICAL ENHANCEMENT, INC
Entity type:Organization
Organization Name:CENTER FOR NEUROPSYCHOLOGICAL ENHANCEMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ANGELO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-424-9212
Mailing Address - Street 1:11882 GREENVILLE AVE STE 121
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3567
Mailing Address - Country:US
Mailing Address - Phone:972-424-9212
Mailing Address - Fax:972-509-1450
Practice Address - Street 1:11882 GREENVILLE AVE STE 121
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3567
Practice Address - Country:US
Practice Address - Phone:972-424-9212
Practice Address - Fax:972-509-1450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00402WMedicare PIN