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General NPI Number Information
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NPI Number | 1770070633
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Entity Type | Organization
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Legal Business Name | NERVIO VIGILAR, LLC
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 04/17/2018
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Provider Practice Location Address
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Address Line | 3400 WATERVIEW PKWY STE 305
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City | RICHARDSON
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State | TX
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Zip | 75080-1566
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Country | US
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Telephone | 214-551-0257
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 WATERVIEW PKWY STE 305
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City | RICHARDSON
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State | TX
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Zip | 75080-1566
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Country | US
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Telephone | 214-551-0257
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CARMEN DAVILA
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Credential |
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Telephone | 214-551-0257
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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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