Organization
PREMIER NEURO DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA SULLIVAN (PRACTICE ADMINISTRATOR)
(903) 259-0550
Entity
Organization
Contact information
Practice address
3301 HAMILTON AVE STE 101, FT WORTH, TX 76107-1847
(817) 529-8488
(903) 328-6568
Mailing address
4455 CAMP BOWIE BLVD # 114-67, FT WORTH, TX 76107-3826
(817) 529-8488
(903) 328-6568
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
Primary
—
—
Other
Enumeration date
11/10/2025
Last updated
11/10/2025
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