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General NPI Number Information
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NPI Number | 1033725940
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Entity Type | Organization
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Legal Business Name | RED RIVER DIAGNOSTICS, PLLC
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Dates
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Enumeration Date | 09/17/2020
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Last Update Date | 09/01/2025
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Provider Practice Location Address
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Address Line | 5001 ROWLETT RD # 4
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City | ROWLETT
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State | TX
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Zip | 75088-3602
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Country | US
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Telephone | 972-412-5299
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Fax | 469-453-3374
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Provider Business Mailing Address
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Address Line | 5001 ROWLETT RD # 4
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City | ROWLETT
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State | TX
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Zip | 75088-3602
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Country | US
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Telephone | 972-412-5299
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Fax | 469-453-3374
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Authorized Official
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Title or Position | MANAGER
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Name | MATTHEW DASILVA
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Credential |
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Telephone | 903-814-1558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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