MEDICARE: NEULINE DIAGNOSTICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	246ZE0500X	EEG Specialist/Technologist
2	246ZE0600X	Electroneurodiagnostic Specialist/Technologist
3	2472E0500X	EEG Technician
4	261QR0200X	Radiology Clinic/Center
5	293D00000X	Physiological Laboratory

General Provider Information

NPI Number	:	1063076883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEULINE DIAGNOSTICS LLC

Provider Business Mailing Address
First Line	:	PO BOX 6529
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-5114
Country	:	US
Telephone Number	:	844-212-5321
Fax Number	:	214-594-9559

Provider Business Practice Location Address
First Line	:	1402 S CUSTER RD STE 302
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-1452
Country	:	US
Telephone Number	:	844-212-5321
Fax Number	:	214-594-9559

Authorized Official
Title or Position	:	OWNER
Name	:	MR. FRANK GRAY III
Credential	:
Telephone Number	:	844-212-5321

Provider Enumeration Date	:	04/26/2019
Last Update Date	:	01/28/2021

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Directions to “NEULINE DIAGNOSTICS LLC ” Practice Location

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