Organization
NORTHSIDE NEURODIAGNOSTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARI TUMU (PRESIDENT)
(512) 538-2175
Entity
Organization
Contact information
Practice address
7421 BURNET RD # 145, AUSTIN, TX 78757-2244
(512) 538-2175
Mailing address
7421 BURNET RD # 145, AUSTIN, TX 78757-2244
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
12/06/2016
Last updated
12/06/2016
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