Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | H2938 | TX |
N | 2084N0600X | Clinical Neurophysiologist | H2938 | TX |
NPI | 1467545004 |
---|---|
Provider Name | Dr. Morris D. Groves JR. |
First Address | Dallas, TX 75391-1230 |
Second Address | Austin, TX 78705-1165 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 11/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
098050003 | (05) | TX |
098050004 | (05) | TX |
98050002 | (05) | TX |
C16351 | (02) | |
P01073116 | RAILROAD MEDICARE (01) | TX |