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Electroneurodiagnostic >> Specialist/Technologist, Other >> Technologists, Technicians & Other Technical Service Providers

Registrant NPI Number: 1558780924

Individual Registrant:
Gender: M
Not Sole Proprietor

Location and contact information for practice:
33518 HALEY RD STE 1  WALLER, TX 77484-5110 US
Tel: 888-344-2947  Fax: 281-622-4381

Contact information for business:
PO BOX 1577  WALLER, TX 77484-1577 US
Tel: 888-344-2947  Fax: 281-622-4381

Registration Information:
NPI: 1558780924
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y246ZE0600XTechnologists, Technicians & Other Technical Service Providers
Specialist/Technologist, Other

Legacy codes, insurance codes and state license numbers:



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