Organization
NEUROPHYSIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NOLAN BRUCE JENEVEIN M.D. (PRESIDENT)
(214) 738-4961
Entity
Organization
Contact information
Practice address
6116 N CENTRAL EXPY, SUITE 1000, DALLAS, TX 75206-5162
(214) 738-4961
Mailing address
8122 SAN FERNANDO WAY, DALLAS, TX 75218-4434
(214) 738-4961
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
H2492
TX
Other
Enumeration date
05/06/2010
Last updated
06/10/2010
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