Provider Demographics
NPI:1659020865
Name:SPRINGWOODS NEURODIAGNOSTICS LLC
Entity Type:Organization
Organization Name:SPRINGWOODS NEURODIAGNOSTICS LLC
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 1:17183 I 45 S STE 590
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-3315
Mailing Address - Country:US
Mailing Address - Phone:936-760-2230
Mailing Address - Fax:
Practice Address - Street 1:17183 I 45 S STE 590
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-3315
Practice Address - Country:US
Practice Address - Phone:936-760-2230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory