1841458254 NPI number — COGNITIVE NEUROSCIENCE SERVICES

Table of content: (NPI 1841458254)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841458254 NPI number — COGNITIVE NEUROSCIENCE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COGNITIVE NEUROSCIENCE SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
RICHARD S COWLES PSYD
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841458254
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
222 W LAS COLINAS BLVD
Provider Second Line Business Mailing Address:
SUITE 1650
Provider Business Mailing Address City Name:
IRVING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75039
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-501-1452
Provider Business Mailing Address Fax Number:
972-401-4091

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
222 W LAS COLINAS BLVD
Provider Second Line Business Practice Location Address:
SUITE 1650
Provider Business Practice Location Address City Name:
IRVING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-501-1452
Provider Business Practice Location Address Fax Number:
972-401-4091
Provider Enumeration Date:
06/02/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
COWLES
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
S
Authorized Official Title or Position:
DIRECTOR CEO
Authorized Official Telephone Number:
972-501-1452

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X , with the licence number:  33276 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)