TEXAS NEURO PHYSIOLOGICAL ASSOCIATES, P.A. - NPI NUMBER 1336399062

Summary

Provider Name: TEXAS NEURO PHYSIOLOGICAL ASSOCIATES, P.A.

NPI Number: 1336399062

Clasification: Psychiatry & Neurology (2084N0600X)

Specialization: Clinical Neurophysiology

Address:
76 STARBRUSH CIR
COVINGTON, LA
ZIP 70433

Phone Number: (985) 845-4595



Detailed Information

TEXAS NEURO PHYSIOLOGICAL ASSOCIATES, P.A. is a clinical neurophysiologist in Covington, LA. The provider is clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). The assigned NPI number for this provider is 1336399062 and is registered as an organization entity type and is a multi-specialty group.

The provider's business address is:

76 STARBRUSH CIR
COVINGTON, LA
ZIP 70433-208
Phone: (985) 845-4595
Fax: (985) 871-6839

The provider's authorized official is Dan William Joachim .
The authorized official title is Medical Director and has the following contact phone number (985) 845-4595.

The enumeration date for this NPI number is 9/30/2008 and was last updated on 9/30/2008.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 2084N0600X Psychiatry & Neurology Clinical Neurophysiology Yes

NPI Record

No. Field Name Field Value
1 NPI 1336399062
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name TEXAS NEURO PHYSIOLOGICAL ASSOCIATES, P.A.
5 Provider First Line Business Practice Location Address 76 STARBRUSH CIR
6 Provider Business Practice Location Address City Name COVINGTON
7 Provider Business Practice Location Address State Name LA
8 Provider Business Practice Location Address Postal Code 704337208
9 Provider Business Practice Location Address Country Code If outside U S US
10 Provider Business Practice Location Address Telephone Number 9858454595
11 Provider Business Practice Location Address Fax Number 9858716839
12 Provider Enumeration Date 9/30/2008
13 Last Update Date 9/30/2008
14 Authorized Official Last Name JOACHIM
15 Authorized Official First Name DAN
16 Authorized Official Middle Name WILLIAM
17 Authorized Official Title or Position MEDICAL DIRECTOR
18 Authorized Official Telephone Number 9858454595
19 Healthcare Provider Taxonomy Code 1 2084N0600X
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Is Organization Subpart N
22 Authorized Official Name Prefix Text DR.
23 Authorized Official Credential Text M.D.
24 Healthcare Provider Taxonomy Group 1 193200000X MULTI-SPECIALTY GROUP

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This page was last updated on: 7/15/2014
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