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General NPI Number Information
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NPI Number | 1740020825
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Entity Type | Organization
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Legal Business Name | PRECISION NEURODIAGNOSTIC LABORATORIES LLC
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Dates
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Enumeration Date | 05/28/2024
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Last Update Date | 03/15/2025
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Provider Practice Location Address
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Address Line | 5555 WEST LOOP S STE 152
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City | BELLAIRE
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State | TX
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Zip | 77401-2100
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Country | US
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Telephone | 713-550-3300
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Fax | 713-554-1701
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Provider Business Mailing Address
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Address Line | PO BOX 152
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City | BELLAIRE
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State | TX
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Zip | 77402-0152
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Country | US
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Telephone | 832-668-9830
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Fax | 713-554-1701
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | ALI ALAVI NAINI
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Credential |
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Telephone | 832-668-9830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number |
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License Number State |
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