Organization
MASH MONITORING PRO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONNA BROOKS (VP OF REVENUE CYCLE)
(972) 665-9930
Entity
Organization
Contact information
Practice address
1400 PRESTON RD, STE 400 ROOM 454, PLANO, TX 75093
(972) 665-9930
Mailing address
PO BOX 815546, DALLAS, TX 75381-5546
(972) 665-9930
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
08/30/2017
Last updated
08/30/2017
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