Organization
NEURO DIAGNOSTIC HOME SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARRYL EVANS J.D. (COO)
(469) 831-7111
Entity
Organization
Contact information
Practice address
1120 S FREEWAY, SUITE 204, FORT WORTH, TX 76104-5064
(469) 831-7111
Mailing address
5904 S COOPER ST, SUITE 104-184, ARLINGTON, TX 76017-4494
(469) 831-7111
Taxonomy
Speciality
Code
Description
License number
State
246ZE0500X
EEG Specialist/Technologist
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
12/09/2010
Last updated
12/09/2010
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