Provider Demographics
NPI:1548416118
Name:TEXAS ELECTRODIAGNOSTICS, PLLC
Entity Type:Organization
Organization Name:TEXAS ELECTRODIAGNOSTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-702-2397
Mailing Address - Street 1:206A S LOOP 336 W
Mailing Address - Street 2:SUITE #269
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3300
Mailing Address - Country:US
Mailing Address - Phone:281-702-2397
Mailing Address - Fax:888-872-6012
Practice Address - Street 1:206A S LOOP 336 W
Practice Address - Street 2:SUITE #269
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3300
Practice Address - Country:US
Practice Address - Phone:281-702-2397
Practice Address - Fax:888-872-6012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty