Provider Demographics
NPI:1619635018
Name:COMPREHENSIVE NEURO SERVICES PC
Entity Type:Organization
Organization Name:COMPREHENSIVE NEURO SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:844-212-5321
Mailing Address - Street 1:PO BOX 6529
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5114
Mailing Address - Country:US
Mailing Address - Phone:844-212-5321
Mailing Address - Fax:214-975-2270
Practice Address - Street 1:19415 DEERFIELD AVE STE 310
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8472
Practice Address - Country:US
Practice Address - Phone:844-212-5321
Practice Address - Fax:214-975-2270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory