Advanced Neuro Management Service Inc.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

129953 Issued in CA

Legal business name

ADVANCED NEURO MANAGEMENT SERVICE INC.

Practice address

2781 Ithaca Place
Lewisville, TX 75067

Phone

(702) 530-7492

Fax

(877) 705-3046

NPI assigned

May 14, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Adam A Siddiqui

Title

Ceo/President

Phone

(214) 972-8151

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1104204783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 297",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "75019",
            "telephone_number": "702-530-7492",
            "fax_number": "877-705-3046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2781 ITHACA PLACE",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "75067",
            "telephone_number": "702-530-7492",
            "fax_number": "877-705-3046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED NEURO MANAGEMENT SERVICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "214-972-8151",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "129953",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "129953",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.