Basic Information
| Provider Information | |||||||||
| NPI: | 1255795324 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | IPA NEUROSURGERY PLLC | ||||||||
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| OtherOrganizationName: | ATX NEUROSURGERY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1058 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782941058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8326303829 | ||||||||
| FaxNumber: | 8326441220 | ||||||||
| Practice Location | |||||||||
| Address1: | 4310 JAMES CASEY ST | ||||||||
| Address2: | STE 3C | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787451251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123262800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2016 | ||||||||
| LastUpdateDate: | 06/13/2016 | ||||||||
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| AuthorizedOfficialLastName: | HOPKINS | ||||||||
| AuthorizedOfficialFirstName: | TIMOTHY | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3252125196 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.