| Neuroscience Institute Of Laredo Pllc | |
|
5711 Mcpherson Rd Ste 100 Laredo TX 78041-6838 | |
| (956) 462-5328 | |
| Not Available |
| Full Name | Neuroscience Institute Of Laredo Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5711 Mcpherson Rd Ste 100, Laredo, Texas |
| Authorized Official Name and Position | Bruce Ballet (CAO) |
| Authorized Official Contact | 8607710622 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuroscience Institute Of Laredo Pllc 5711 Mcpherson Rd Ste 100 Laredo TX 78041-6838 Ph: () - | Neuroscience Institute Of Laredo Pllc 5711 Mcpherson Rd Ste 100 Laredo TX 78041-6838 Ph: (956) 462-5328 |
| NPI Number | 1578218244 |
|---|---|
| Provider Enumeration Date | 02/21/2022 |
| Last Update Date | 09/01/2022 |
| Certification Date | 09/01/2022 |
| Medicare PECOS PAC ID | 7416334412 |
|---|---|
| Medicare Enrollment ID | O20220512002008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578218244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Randall Wright |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316035058 PECOS PAC ID: 5092799262 Enrollment ID: I20040615001394 |
| Provider Name | Zakaria Siddiq |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326083072 PECOS PAC ID: 8628071107 Enrollment ID: I20060823000373 |
| Provider Name | Usha Aryal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073712287 PECOS PAC ID: 2163657362 Enrollment ID: I20131024000090 |
| Provider Name | Nora Bolanos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578964177 PECOS PAC ID: 3870816119 Enrollment ID: I20141218000229 |
| Provider Name | Daniel S Sa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427075308 PECOS PAC ID: 6901809375 Enrollment ID: I20150206001635 |
| Provider Name | Lorie Ann Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679097588 PECOS PAC ID: 8921374026 Enrollment ID: I20200406000279 |
| Provider Name | Jason John Madey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245466937 PECOS PAC ID: 2062791569 Enrollment ID: I20220203000892 |
| Provider Name | Justin A Canter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194274100 PECOS PAC ID: 2961783964 Enrollment ID: I20220517001023 |
| Provider Name | Michlene Rae Passeri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649711094 PECOS PAC ID: 1254733710 Enrollment ID: I20220613002868 |
| Provider Name | Muhammad T A Malik |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528487816 PECOS PAC ID: 3971806134 Enrollment ID: I20220627001327 |
| Provider Name | George Abraham Khouri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609138866 PECOS PAC ID: 4587987268 Enrollment ID: I20220831003517 |
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