Organization
FOUR STATES NEURO TECH, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRASE MAHAN (MANAGER)
(214) 675-0905
Entity
Organization
Contact information
Practice address
4516 LOVERS LN # 331, DALLAS, TX 75225-6925
(214) 675-0905
(214) 317-4888
Mailing address
PO BOX 702620, TULSA, OK 74170-2620
(214) 675-0905
(214) 317-4888
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
07/06/2012
Last updated
07/06/2012
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