Southwest Electrodiagnostic Center Llc | |
16135 Preston Rd Ste 135 Box 21 Dallas TX 75248-3590 | |
(866) 620-5987 | |
Not Available |
Full Name | Southwest Electrodiagnostic Center Llc |
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Speciality | Psychiatry & Neurology - Neurology |
Location | 16135 Preston Rd Ste 135, Dallas, Texas |
Authorized Official Name and Position | Henry G Raroque (MANAGER) |
Authorized Official Contact | 8666205987 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Southwest Electrodiagnostic Center Llc Po Box 794564 Dallas TX 75379-4564 Ph: () - | Southwest Electrodiagnostic Center Llc 16135 Preston Rd Ste 135 Box 21 Dallas TX 75248-3590 Ph: (866) 620-5987 |
NPI Number | 1518226521 |
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Provider Enumeration Date | 05/10/2012 |
Last Update Date | 05/10/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518226521 | NPI | - | NPPES |
H6748 | Other | TX | LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | H6748 (Texas) | Primary |
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