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General NPI Number Information
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NPI Number | 1518331172
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Entity Type | Organization
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Legal Business Name | NEURO BRAIN CENTER OF AMERICA, LLC
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 02/03/2016
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Provider Practice Location Address
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Address Line | 521 W SOUTHLAKE BLVD SUITE 100
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6173
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Country | US
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Telephone | 817-488-3238
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Fax |
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Provider Business Mailing Address
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Address Line | 521 W SOUTHLAKE BLVD SUITE 100
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6173
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Country | US
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Telephone | 817-488-3238
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BART STEELE
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Credential |
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Telephone | 817-488-3238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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