Provider Demographics
NPI:1982334827
Name:BRAINTECH LLC
Entity Type:Organization
Organization Name:BRAINTECH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZAK
Authorized Official - Middle Name:T
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-286-1016
Mailing Address - Street 1:11901 N MACARTHUR BLVD STE C5
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-1852
Mailing Address - Country:US
Mailing Address - Phone:405-286-1016
Mailing Address - Fax:405-242-2016
Practice Address - Street 1:11901 N MACARTHUR BLVD STE C5
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-1852
Practice Address - Country:US
Practice Address - Phone:405-286-1016
Practice Address - Fax:405-242-2016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEGGroup - Single Specialty