Provider Demographics
NPI:1164510392
Name:NEUROLOGY & NEUROPHYSIOLOGY, PA
Entity type:Organization
Organization Name:NEUROLOGY & NEUROPHYSIOLOGY, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THIMIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTALAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-798-7246
Mailing Address - Street 1:2425 BABCOCK RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4895
Mailing Address - Country:US
Mailing Address - Phone:210-614-5242
Mailing Address - Fax:210-614-3076
Practice Address - Street 1:2425 BABCOCK RD
Practice Address - Street 2:SUITE 111
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4895
Practice Address - Country:US
Practice Address - Phone:210-614-5242
Practice Address - Fax:210-614-3076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2686HMOtherBLUE CROSS/BLUE SHILED TX