Healthcare Provider Details

I. General information

NPI: 1437677358
Provider Name (Legal Business Name): MASH MONITORING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 08/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PRESTON RD STE 400 ROOM 454
PLANO TX
75093
US

IV. Provider business mailing address

PO BOX 815546
DALLAS TX
75381-5546
US

V. Phone/Fax

Practice location:
  • Phone: 972-665-9930
  • Fax:
Mailing address:
  • Phone: 972-665-9930
  • Fax:

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 Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: RONNA BROOKS
Title or Position: VP REVENUE CYCLE
Credential:
Phone: 972-665-9930