# BRAINHERTZ NEURODIAGNOSTIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043763493
- **Authorized official:** TIA COOKS (ADMINISTRATOR)
- **Authorized official phone:** (469) 490-1270

## Contact information

- **Practice address:** 1801 N HAMPTON RD STE 416, DESOTO, TX 75115-2420
- **Practice address phone:** (214) 437-1932
- **Mailing address:** 2700 WHISPERING OAKS CV, CEDAR HILL, TX 75104-8243
- **Mailing address phone:** (214) 437-1932

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2472E0500X | EEG Technician | — | NULL | — |
| 2472E0500X | EEG Technician | — | — | — |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 08/02/2016
- **Last updated:** 05/03/2023