Organization
SOUTHWEST NEUROPHYSIOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
UYENLY NGUYEN CNIM R. EPT., R CNST (OWNER)
(469) 343-5989
Entity
Organization
Contact information
Practice address
2452 LAKEWOOD DR, GRAND PRAIRIE, TX 75054-6800
(469) 343-5989
(888) 516-0585
Mailing address
PO BOX 3591, COPPELL, TX 75019-5546
(469) 343-5984
(888) 516-0585
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00LZ77
BCBS RECORD ID
TX
Enumeration date
07/15/2019
Last updated
02/18/2021
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