Provider Demographics
NPI:1184156341
Name:ATX NEUROLOGICAL SOLUTIONS AMBULATORY EEG
Entity type:Organization
Organization Name:ATX NEUROLOGICAL SOLUTIONS AMBULATORY EEG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:LEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-800-8978
Mailing Address - Street 1:13409 BOLIVIA DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-8053
Mailing Address - Country:US
Mailing Address - Phone:512-800-8978
Mailing Address - Fax:
Practice Address - Street 1:13409 BOLIVIA DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-8053
Practice Address - Country:US
Practice Address - Phone:512-800-8978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED SLEEP CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEGGroup - Single Specialty