Provider Demographics
NPI:1750387635
Name:TENNESSEE ADVANCED NEURODIAGNOSTIC INSTITUTE, INC. (TANII)
Entity type:Organization
Organization Name:TENNESSEE ADVANCED NEURODIAGNOSTIC INSTITUTE, INC. (TANII)
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DRIBER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:615-463-3034
Mailing Address - Street 1:PO BOX 601449
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75360-1449
Mailing Address - Country:US
Mailing Address - Phone:214-368-9966
Mailing Address - Fax:214-368-9977
Practice Address - Street 1:4525 HARDING RD
Practice Address - Street 2:STE 102
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2145
Practice Address - Country:US
Practice Address - Phone:615-463-3034
Practice Address - Fax:615-463-3187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7980634OtherAETNA
TN3791325Medicaid
TN7980634OtherAETNA