| Dallas Neuroscience, P.a. | |
|
1001 Robbie Mince Way Ste C Desoto TX 75115-2012 | |
| (214) 941-7655 | |
| (214) 941-7626 |
| Full Name | Dallas Neuroscience, P.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1001 Robbie Mince Way Ste C, Desoto, Texas |
| Authorized Official Name and Position | Lorena Jones (ADMINISTRATOR) |
| Authorized Official Contact | 2149417655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dallas Neuroscience, P.a. 1001 Robbie Mince Way Ste C Desoto TX 75115-2012 Ph: (214) 941-7655 | Dallas Neuroscience, P.a. 1001 Robbie Mince Way Ste C Desoto TX 75115-2012 Ph: (214) 941-7655 |
| NPI Number | 1629265558 |
|---|---|
| Provider Enumeration Date | 09/25/2007 |
| Last Update Date | 01/17/2022 |
| Certification Date | 01/17/2022 |
| Medicare PECOS PAC ID | 0648354746 |
|---|---|
| Medicare Enrollment ID | O20080228000285 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629265558 | NPI | - | NPPES |
| 192232001 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Yong He |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710979133 PECOS PAC ID: 2961434998 Enrollment ID: I20050909000806 |
| Provider Name | Gurubasappa Motgi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1285626572 PECOS PAC ID: 5092899195 Enrollment ID: I20080228000134 |
| Provider Name | Richard S Ahn |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700878071 PECOS PAC ID: 7810071917 Enrollment ID: I20080228000135 |
| Provider Name | David Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609868918 PECOS PAC ID: 1850475971 Enrollment ID: I20080228000427 |
| Provider Name | Rosa Arcadia Luna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437409141 PECOS PAC ID: 0446495022 Enrollment ID: I20171018000102 |
| Provider Name | Niangui Wang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295907178 PECOS PAC ID: 3779633623 Enrollment ID: I20171228002789 |
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