Provider Demographics
NPI:1346799681
Name:BRILEY, DAVID (CNIM 3351)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BRILEY
Suffix:
Gender:M
Credentials:CNIM 3351
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 HILLCREST ST STE 700
Mailing Address - Street 2:
Mailing Address - City:LAKE DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75065-2330
Mailing Address - Country:US
Mailing Address - Phone:178-569-0067
Mailing Address - Fax:
Practice Address - Street 1:106 HILLCREST ST STE 700
Practice Address - Street 2:
Practice Address - City:LAKE DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75065-2330
Practice Address - Country:US
Practice Address - Phone:178-569-0067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic