Provider Demographics
NPI:1710864616
Name:BLUE CACTUS NEUROLOGY
Entity type:Organization
Organization Name:BLUE CACTUS NEUROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMZY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDAA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-865-0398
Mailing Address - Street 1:14362 N FRANK LLOYD WRIGHT BLVD STE 1330
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-8878
Mailing Address - Country:US
Mailing Address - Phone:713-865-0398
Mailing Address - Fax:
Practice Address - Street 1:14362 N FRANK LLOYD WRIGHT BLVD STE 1330
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-8878
Practice Address - Country:US
Practice Address - Phone:480-900-5154
Practice Address - Fax:480-900-0959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-20
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center