Provider Demographics
NPI:1851715460
Name:BRAINCARE, LLC
Entity Type:Organization
Organization Name:BRAINCARE, LLC
Other - Org Name:GLOBAL NEURO-DIAGNOSTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-998-1548
Mailing Address - Street 1:2670 FIREWHEEL DR
Mailing Address - Street 2:STE B
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-4601
Mailing Address - Country:US
Mailing Address - Phone:866-848-2522
Mailing Address - Fax:972-692-8389
Practice Address - Street 1:16427 N SCOTTSDALE RD
Practice Address - Street 2:STE 410
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-8197
Practice Address - Country:US
Practice Address - Phone:866-848-2522
Practice Address - Fax:972-692-8389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ165496Medicare PIN