| NPI | 1760399869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA SULLIVAN Practice Administrator 903-259-0550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine |
| Enumeration Date | 2026-08-25 |
| Last Update Date | 2026-09-02 |