Mrs Neurosurgical Clinic

Primary specialty

SpecialistTaxonomy code 174400000X

License

H3003 Issued in TX

Legal business name

MRS NEUROSURGICAL CLINIC

Practice address

4001 W 15TH St
Suite 260
Plano, TX 75093-5841

Phone

(214) 778-2530

Fax

(214) 778-2542

NPI assigned

Aug 13, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Sandra K Herron

Title

Billing Director

Phone

(214) 778-2530

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Chang Neurosurgery and Spinecare Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen F Lummus, PA-C

  • Physician Assistant
  • Longview, TX
  • NPI 1255528006
  NPD (past)
• Elaine Catherine Kiser-Rude, PA-C

  • Physician Assistant
  • Tacoma, WA
  • NPI 1083919682
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327190400000",
    "number": "1023240751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 262449",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750262449",
            "telephone_number": "214-778-2530",
            "fax_number": "214-778-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 W 15TH ST",
            "address_2": "SUITE 260",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935841",
            "telephone_number": "214-778-2530",
            "fax_number": "214-778-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRS NEUROSURGICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-13",
        "last_updated": "2012-01-22",
        "status": "A",
        "authorized_official_last_name": "HERRON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "214-778-2530",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "H3003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285096801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1023240751",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1659364412",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP PROVIDER NUMBER",
            "identifier": "0039SQ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chang Neurosurgery and Spinecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Maite Moyers, PHARMD
• Jennifer Archer Moylon, PA-C
• Ananya Mozumdar
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• Jane Njeri Muchiri
• Amanda Suzanne Anuenue Muck, PA-C
• Malini Mudduluru, MD

• Specialist in Plano, TX
• Providers in Plano, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.