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General NPI Number Information
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NPI Number | 1982979282
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Entity Type | Organization
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Legal Business Name | CONNEXIONS MEDICAL DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 03/20/2012
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Last Update Date | 10/26/2012
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Provider Practice Location Address
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Address Line | 701 E PLANO PKWY STE 115
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City | PLANO
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State | TX
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Zip | 75074-6751
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Country | US
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Telephone | 972-801-8051
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Fax |
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Provider Business Mailing Address
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Address Line | 701 E PLANO PKWY STE 115
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City | PLANO
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State | TX
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Zip | 75074-6751
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Country | US
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Telephone | 972-801-8051
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAULA CALL CORNEJO
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Credential | R.EEG.T
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Telephone | 972-801-8051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 261QM2500X
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License Number State | TX
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