Organization
HOMESTEAD NEURO DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLIFTON ALBERT JACOB EDWARDS MHA, PMP, CPHQ (OWNER/MANAGER)
(832) 469-1155
Entity
Organization
Contact information
Practice address
8403 STATE HIGHWAY 151, STE 104 #111, SAN ANTONIO, TX 78245-2199
(832) 469-1155
Mailing address
8403 STATE HIGHWAY 151, STE 104 #111, SAN ANTONIO, TX 78245-2199
(832) 469-1155
Taxonomy
Speciality
Code
Description
License number
State
2472E0500X
EEG Technician
Primary
—
—
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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