Organization
CLAN IOM, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEDRO LOREDO M.D. (PRESIDENT)
(469) 283-0568
Entity
Organization
Contact information
Practice address
3824 CEDAR SPRINGS RD # 340, DALLAS, TX 75219-4136
(469) 283-0568
Mailing address
3824 CEDAR SPRINGS RD # 340, DALLAS, TX 75219-4136
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
08/25/2015
Last updated
11/15/2016
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