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Organization
BRAINWAVE NEURODIAGNOSTICS LLC
Active
Organization
BRAINWAVE NEURODIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIBU MALAICKAL (OWNER)
(214) 686-9393
Entity
Organization
Contact information
Practice address
4541 MEDICAL CENTER DR, MCKINNEY, TX 75069-1651
(214) 686-9393
Mailing address
304 S COPPELL RD, COPPELL, TX 75019-2417
(214) 686-9393
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
01/08/2020
Last updated
01/08/2020
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