PROVIDENCE NEUROLOGY CLINIC PA – NPI #1144555251
Psychiatry & Neurology

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

Health Care Provider Taxonomy Code for Psychiatry & Neurology

PROVIDENCE NEUROLOGY CLINIC PA is a psychiatry & neurologist located in LAREDO, TX. NPPES has assigned the NPI number 1144555251 to PROVIDENCE NEUROLOGY CLINIC PA on October 07, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2084N0400X from the Health Care Provider Taxonomy code set, which is classified as Psychiatry & Neurology, specializing in Neurology

The NPI profile was previously updated about 14 years ago on Jun 21, 2012. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PROVIDENCE NEUROLOGY CLINIC PA below.

NPI Profile for
PROVIDENCE NEUROLOGY CLINIC PA

NPI Number
1144555251
Enumeration Date

(more than 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PROVIDENCE NEUROLOGY CLINIC PA
Primary location
220 W HILLSIDE RD
SUITE 5 B
LAREDO, TX 78041-6903
Phone: (956) 717-4074 Fax: (956) 717-4186
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
GRACE MUKAMANA
MD/OWNER
Phone: (956) 717-4074
Updated
Identifiers

Identifiers for PROVIDENCE NEUROLOGY CLINIC PA

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDTX210191701
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2084N0400X
- Psychiatry & Neurology / Neurology (Primary)		 TX N3913
2084N0600X
- Psychiatry & Neurology / Clinical Neurophysiology		 TX N3913

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.