| NPI | 1760841258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ALEC TISDALL Owner 210-714-5532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic | |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2016-11-16 |