Healthcare Provider Details

I. General information

NPI: 1780217216
Provider Name (Legal Business Name): BYWATER HEALTHCARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2020
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5616 WARREN PKWY STE 100
FRISCO TX
75034-4165
US

IV. Provider business mailing address

101 N GREENVILLE AVE.STE C #59 #59
ALLEN TX
75002
US

V. Phone/Fax

Practice location:
  • Phone: 214-817-4222
  • Fax: 469-754-0416
Mailing address:
  • Phone: 972-370-5771
  • Fax: 972-674-2788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMEER ALI SYED
Title or Position: PRESIDENT
Credential:
Phone: 972-370-5771