Organization
SELECT DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH WEATHERWAX (AUTHORIZED OFFICIAL)
(469) 646-8663
Entity
Organization
Contact information
Practice address
535 E. FERNHURST DR, STE 111, KATY, TX 77450-1431
(888) 280-6332
(888) 252-7043
Mailing address
8222 DOUGLAS AVE, STE 820, DALLAS, TX 75225
(469) 646-8663
(888) 252-7043
Taxonomy
Speciality
Code
Description
License number
State
246ZE0500X
EEG Specialist/Technologist
Primary
—
—
293D00000X
Physiological Laboratory
—
—
Other
Enumeration date
10/09/2017
Last updated
12/20/2018
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