Provider Demographics
NPI:1568596377
Name:SEMICH, STEVEN MICHAEL (R EEGT/EPT, CNIM)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:MICHAEL
Last Name:SEMICH
Suffix:
Gender:M
Credentials:R EEGT/EPT, CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14983 BOAZ LN
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-4801
Mailing Address - Country:US
Mailing Address - Phone:903-530-9779
Mailing Address - Fax:214-919-2560
Practice Address - Street 1:14983 BOAZ LN
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-4801
Practice Address - Country:US
Practice Address - Phone:903-530-9779
Practice Address - Fax:903-882-7748
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX804210478246ZE0500X
TX224246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG