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Individual

DR. RUSSELL TENNYSON TOLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
771 E SOUTHLAKE BLVD STE 222, SOUTHLAKE, TX 76092-7065
(817) 888-6974
Mailing address
771 E SOUTHLAKE BLVD STE 222, SOUTHLAKE, TX 76092-7065
(817) 888-6974

Taxonomy

Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
246ZB0301X
Biomedical Engineer
Primary
246ZE0500X
EEG Specialist/Technologist

Other

Enumeration date
12/19/2022
Last updated
08/28/2025
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