Neuro Rehab Associates PA

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

E5103 Issued in TX

Legal business name

NEURO REHAB ASSOCIATES PA

Practice address

680 N Carroll Ave
Suite 120
Southlake, TX 76092-6467

Phone

(817) 421-9111

Fax

(817) 421-9222

NPI assigned

Sep 18, 2007

Organization subpart

No

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

Authorized official

Name

Tina Davidovich

Title

Director

Phone

(817) 421-9111

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190073600000",
    "number": "1376739805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 92248",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760920103",
            "telephone_number": "817-421-9111",
            "fax_number": "817-421-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N CARROLL AVE",
            "address_2": "SUITE 120",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926467",
            "telephone_number": "817-421-9111",
            "fax_number": "817-421-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO REHAB ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2007-09-18",
        "status": "A",
        "authorized_official_last_name": "DAVIDOVICH",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "817-421-9111"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "TX",
            "license": "E5103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bianca Nazario
• Thomas Manning Neale Jr., RPH
• Neogen Mental Health and Behavioral Services, PA.
• Danielle Brooke Ness, FNP-C
• Neuro Brain Center of America, LLC
• Neurocare Centre of North Texas, PLLC
• Neuromuscular Corporate Solutions
• Neuropsychology Associates of North Texas
• New Solutions Counseling, PLLC
• Dakota Marie Newman, MA

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Southlake, TX
• Providers in Southlake, TX by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; 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.