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General NPI Number Information
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NPI Number | 1427761857
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Entity Type | Organization
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Legal Business Name | TEXOMA NEURODIAGNOSTICS PLLC
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Dates
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Enumeration Date | 12/30/2022
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Last Update Date | 11/19/2024
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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 | ADMIN
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Name | LISAMARIE PARTRIDGE
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Credential | CMC, CMRS
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Telephone | 729-412-5299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204R00000X
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Taxonomy Name | Electrodiagnostic Medicine 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 | 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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