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NPI Code Detail

MEDICARE: MR. TIMMY DEE NEWTON BS, R EEGT, CNIM

MEDICARE: MR. TIMMY DEE NEWTON BS, R EEGT, CNIM
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
12472E0500XEEG Technician
2246ZE0600XElectroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number : 1609078567
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIMMY DEE NEWTON BS, R EEGT, CNIM
Provider Business Mailing Address
First Line : 14983 BOAZ LN
Second Line :
City : LINDALE
State : TX
Zip : 75771-4801
Country : US
Telephone Number : 972-786-6167
Fax Number : 903-882-7748
Provider Business Practice Location Address
First Line : 14983 BOAZ LN STE 112
Second Line :
City : LINDALE
State : TX
Zip : 75771-4801
Country : US
Telephone Number : 972-786-6167
Fax Number : 903-882-7748
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2007
Last Update Date : 09/02/2021

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