Individual
MR. GEORGE W. WHITEHEAD IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNIM
Contact information
Practice address
1819 JAY ELL DR, RICHARDSON, TX 75081-2063
(888) 344-2947
(888) 694-2947
Mailing address
1819 JAY ELL DR, RICHARDSON, TX 75081-2063
(888) 344-2947
(888) 694-2947
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
1104
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104
CNIM
—
Enumeration date
08/10/2020
Last updated
08/10/2020
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