Provider Demographics
NPI:1730362278
Name:NEUROLOGICAL SPECIALISTS OF MCKINNEY PLLC
Entity type:Organization
Organization Name:NEUROLOGICAL SPECIALISTS OF MCKINNEY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-401-8726
Mailing Address - Street 1:4510 MEDICAL CENTER DR
Mailing Address - Street 2:STE 300
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1650
Mailing Address - Country:US
Mailing Address - Phone:214-544-1300
Mailing Address - Fax:214-544-1300
Practice Address - Street 1:4510 MEDICAL CENTER DR
Practice Address - Street 2:STE 300
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1650
Practice Address - Country:US
Practice Address - Phone:214-544-1300
Practice Address - Fax:214-544-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX192868101Medicaid
TX192868101Medicaid
TX00Y358Medicare PIN