Neurointerp, PLLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

H2492 Issued in TX

Legal business name

NEUROINTERP, PLLC

Practice address

4025 Stanford Ave
Dallas, TX 75225-7006

Phone

(121) 453-6164

Fax

(214) 536-1647

NPI assigned

Aug 18, 2017

Organization subpart

No

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

Authorized official

Name

Nolan Bruce Jenevein, MD

Title

President

Phone

(214) 738-4961

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503014400000",
    "number": "1730605940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 W LOVERS LN STE 116-133",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752094330",
            "telephone_number": "214-536-1647",
            "fax_number": "214-580-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 STANFORD AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752257006",
            "telephone_number": "121-453-6164",
            "fax_number": "214-536-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROINTERP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2017-08-18",
        "status": "A",
        "authorized_official_last_name": "JENEVEIN",
        "authorized_official_first_name": "NOLAN",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-738-4961",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "H2492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Neurology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2017; 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.