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General NPI Number Information
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NPI Number | 1083800288
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Entity Type | Organization
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Legal Business Name | NERVE DIAGNOSTIC CENTER
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 05/28/2008
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Provider Practice Location Address
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Address Line | 801 E FERN AVE SUITE 108
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City | MCALLEN
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State | TX
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Zip | 78501-1496
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Country | US
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Telephone | 956-463-9297
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8034
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City | WESLACO
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State | TX
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Zip | 78599-8034
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Country | US
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Telephone | 956-463-9297
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | MR. CHRISTOPHER NOEL DELEON
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Credential |
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Telephone | 956-684-9841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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