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General NPI Number Information
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NPI Number | 1780818740
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Entity Type | Organization
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Legal Business Name | NEURO ANALYSIS DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 06/02/2011
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Provider Practice Location Address
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Address Line | 20403 UNIVERSITY BLVD SUITE #300
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City | SUGAR LAND
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State | TX
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Zip | 77478-3558
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Country | US
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Telephone | 281-302-5983
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Fax | 832-365-6065
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Provider Business Mailing Address
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Address Line | 20403 UNIVERSITY BLVD SUITE #300
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City | SUGAR LAND
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State | TX
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Zip | 77478-3558
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Country | US
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Telephone | 281-302-5983
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Fax | 832-365-6065
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TIM C ALDRIDGE
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Credential | RRT
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Telephone | 281-302-5983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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