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General NPI Number Information
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NPI Number | 1669908000
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Entity Type | Organization
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Legal Business Name | TLE HEALTHCARE TECHNOLOGIES LLC
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Dates
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Enumeration Date | 05/04/2017
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 3400 BURRWOOD CIR
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City | CORINTH
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State | TX
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Zip | 76208-5440
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Country | US
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Telephone | 214-912-2256
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Fax | 800-942-1772
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Provider Business Mailing Address
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Address Line | PO BOX 1598
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City | LAKE DALLAS
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State | TX
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Zip | 75065-1598
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Country | US
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Telephone | 214-912-2256
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Fax | 800-942-1772
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. JOHN KELLOGG SR.
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Credential |
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Telephone | 214-912-2256
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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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