Provider Demographics
NPI:1366077984
Name:DALLAS ADVANCED NEUROSURGICAL CENTER PLLC
Entity type:Organization
Organization Name:DALLAS ADVANCED NEUROSURGICAL CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:GADARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-937-4861
Mailing Address - Street 1:2900 MCKINNON ST APT 2708
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-0900
Mailing Address - Country:US
Mailing Address - Phone:512-937-4861
Mailing Address - Fax:214-888-4450
Practice Address - Street 1:2900 MCKINNON ST APT 2708
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-0900
Practice Address - Country:US
Practice Address - Phone:512-937-4861
Practice Address - Fax:214-888-4450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty