Healthcare Provider Details

I. General information

NPI: 1962720102
Provider Name (Legal Business Name): GLOBAL NEURO-DIAGNOSTICS, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 DENVER ST
MUSKOGEE OK
74401-5334
US

IV. Provider business mailing address

1278 JUSTIN RD SUITE 109
LEWISVILLE TX
75077-2200
US

V. Phone/Fax

Practice location:
  • Phone: 918-682-3380
  • Fax: 877-290-1544
Mailing address:
  • Phone: 866-848-2522
  • Fax: 877-290-1544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: STEVEN CHARLES ESTES
Title or Position: COO/PARTNER
Credential: REEGT
Phone: 972-998-1548