Organization
NET NEURODIAGNOSTIC CLINIC,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY L FREELEN (OFFICE COORDINATOR)
(903) 784-1593
Entity
Organization
Contact information
Practice address
2655 NE LOOP 286, PARIS, TX 75460-3444
(903) 784-1593
(903) 784-6807
Mailing address
2655 NE LOOP 286, PARIS, TX 75460-3444
(903) 784-1593
(903) 784-6807
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
J7476
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00924N
PTAN
TX
05
—
081374301
—
TX
Enumeration date
03/07/2007
Last updated
01/09/2013
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