Provider Demographics
NPI:1174946636
Name:NATIONWIDE NEURO HEALTH, PLLC
Entity type:Organization
Organization Name:NATIONWIDE NEURO HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WADE
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-454-0567
Mailing Address - Street 1:1825 S KIMBALL AVE
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83605-4828
Mailing Address - Country:US
Mailing Address - Phone:208-454-0567
Mailing Address - Fax:208-402-6635
Practice Address - Street 1:6430 HILLCROFT ST
Practice Address - Street 2:100-A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-3191
Practice Address - Country:US
Practice Address - Phone:972-526-5444
Practice Address - Fax:972-526-5445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty