| Black Willow Operations, Llc | |
|
6900 Dallas Pkwy Suite 800 Plano TX 75024-7144 | |
| (214) 396-7227 | |
| (469) 453-5192 |
| Full Name | Black Willow Operations, Llc |
|---|---|
| Speciality | Specialist/technologist, Other - Electroneurodiagnostic |
| Location | 6900 Dallas Pkwy, Plano, Texas |
| Authorized Official Name and Position | D Richard Henry (CEO) |
| Authorized Official Contact | 2143967227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Willow Operations, Llc 6900 Dallas Pkwy Suite 800 Plano TX 75024-7144 Ph: (214) 396-7227 | Black Willow Operations, Llc 6900 Dallas Pkwy Suite 800 Plano TX 75024-7144 Ph: (214) 396-7227 |
| NPI Number | 1053842641 |
|---|---|
| Provider Enumeration Date | 03/24/2017 |
| Last Update Date | 03/29/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053842641 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 246ZE0600X | Specialist/technologist, Other - Electroneurodiagnostic | (* (Not Available)) | Primary |
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