PK NEUROLOGY PLLC NPI 1104763051

NPI Information

NPI: 1104763051
Provider Name: PK NEUROLOGY PLLC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address: 455 N MESA DR STE 5
MESA, AZ
ZIP 85201
Phone: (480) 813-2906

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NPI Details

PK NEUROLOGY PLLC is a general practice in Mesa, AZ. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee PK NEUROLOGY PLLC NPI is 1104763051. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

455 N MESA DR STE 5
MESA, AZ
ZIP 85201-936
Phone: (480) 813-2906

The provider's authorized official is Paul Lanier .
The authorized official title is Principal and has the following contact phone number (801) 471-7340.

The enumeration date for this NPI number is 4/29/2026 and was last updated on 4/29/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	103TA0700X	Psychologist	Adult Development & Aging	No
2	103TM1800X	Psychologist	Intellectual and Developmental Disabilities	No
3	225100000X	Physical Therapist		No
4	225XN1300X	Occupational Therapist	Neurorehabilitation	No
5	208D00000X	General Practice		Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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