Organization · NPI-2

Abilene Neurowatch PLLC

Electrodiagnostic Medicine · Ft Worth, TX

NPI number1508335084
StatusActive
Last updated in NPPESNov 14, 2018

Details

NPI
1508335084
Entity type
Organization (NPI-2)
Legal business name
Abilene Neurowatch PLLC
Organization subpart
No
Enumeration date
Nov 14, 2018
Last updated
Nov 14, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
204R00000X Electrodiagnostic Medicine––Yes

Practice location

111 Boland St Ste 211
Ft Worth, TX 76107-1265

Phone 214-269-3875 · Fax 903-328-6568

Mailing address

111 Boland St Ste 211
Ft Worth, TX 76107-1265

Authorized official

Gina Sullivan
Billing Manager
2142693875

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