Provider Demographics
NPI:1083800288
Name:NERVE DIAGNOSTIC CENTER
Entity Type:Organization
Organization Name:NERVE DIAGNOSTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:DELEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-684-9841
Mailing Address - Street 1:PO BOX 8034
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-8034
Mailing Address - Country:US
Mailing Address - Phone:956-463-9297
Mailing Address - Fax:
Practice Address - Street 1:801 E FERN AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-1496
Practice Address - Country:US
Practice Address - Phone:956-463-9297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No171W00000XOther Service ProvidersContractorGroup - Single Specialty