Organization
KIOM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY WILLIAMS (SOLE MEMBER)
(785) 341-2460
Entity
Organization
Contact information
Practice address
2060 WILLOW BEND CT, PROSPER, TX 75078-9485
(972) 412-5299
(469) 453-3374
Mailing address
11625 CUSTER RD STE 110-154, FRISCO, TX 75035-8783
(972) 412-5299
(469) 453-3374
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
2472E0500X
EEG Technician
—
—
Other
Enumeration date
11/16/2019
Last updated
01/18/2021
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