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General NPI Number Information
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NPI Number | 1750478913
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Entity Type | Organization
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Legal Business Name | NEUROLOGY DIAGNOSTIC CENTERS OF DALLAS INC
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 09/04/2012
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Provider Practice Location Address
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Address Line | 9301 N CENTRAL EXPY STE 585
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City | DALLAS
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State | TX
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Zip | 75231-0811
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Country | US
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Telephone | 214-363-3623
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Fax | 214-363-0869
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Provider Business Mailing Address
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Address Line | 9301 N CENTRAL EXPY STE 585
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City | DALLAS
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State | TX
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Zip | 75231-0811
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Country | US
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Telephone | 214-363-3623
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Fax | 214-363-0869
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Authorized Official
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Title or Position | OWNER
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Name | ZIAD A BLAIK
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Credential | M.D.
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Telephone | 214-363-3623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K6814
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License Number State | TX
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