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General NPI Number Information
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NPI Number | 1376218396
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Entity Type | Organization
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Legal Business Name | MOBILE EEG TESTING INC
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | 1420 N COOPER ST STE 110
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City | ARLINGTON
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State | TX
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Zip | 76011-8530
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Country | US
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Telephone | 800-323-1771
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Fax | 817-483-4068
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Provider Business Mailing Address
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Address Line | 4101 W GREEN OAKS BLVD STE 305
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City | ARLINGTON
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State | TX
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Zip | 76016-6800
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Country | US
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Telephone | 800-323-1771
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Fax | 817-483-4068
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Authorized Official
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Title or Position | OWNER
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Name | MAHNAZ J DARVISHY
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Credential |
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Telephone | 817-405-7582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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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 | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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