Provider Demographics
NPI:1518256031
Name:JONES, BROOKE (CNIM)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNIM
Mailing Address - Street 1:4100 W 15TH ST
Mailing Address - Street 2:STE 206
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5803
Mailing Address - Country:US
Mailing Address - Phone:972-599-1055
Mailing Address - Fax:972-596-7570
Practice Address - Street 1:4100 W 15TH ST
Practice Address - Street 2:STE 206
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5803
Practice Address - Country:US
Practice Address - Phone:972-599-1055
Practice Address - Fax:972-596-7570
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1265246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic