Provider Demographics
NPI:1336390095
Name:NOVAKOV, GEORGI (CNIM, DABNM)
Entity Type:Individual
Prefix:MR
First Name:GEORGI
Middle Name:
Last Name:NOVAKOV
Suffix:
Gender:M
Credentials:CNIM, DABNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2346 MORGAN RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-3318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25 HIGHLAND PARK VLG
Practice Address - Street 2:STE 100-225
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-2789
Practice Address - Country:US
Practice Address - Phone:214-536-1647
Practice Address - Fax:214-580-7600
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic