BRAINWAVE DIAGNOSTIC LLC (NPI# 1184283053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184283053 |
| Entity Type | Organization |
| Organization Name | BRAINWAVE DIAGNOSTIC LLC |
| Practice Address |
7777 Forest Ln Ste B416 Dallas TX 75230-2566 |
| Mailing Address |
Po Box 6529 Mckinney TX 75071-5114 |
| Practice Telephone | 8442125321 |
| Mailing Telephone | 8442125321 |
| Mailing Fax Number | 2145949559 |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2019-06-13 |
| Authorized Official Name | MATIAS DAY (OWNER) |
| Authorized Official Telephone | 8442125321 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| Street Address |
7777 FOREST LN STE B416 |
| City | DALLAS |
| State | TX |
| Zip Code | 75230-2566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912552415 | Kyoto Medical Services, Pllc | Orthopaedic Surgery | 12890 Hillcrest Plaza Drive, Suite K111, Dallas, TX 75230 | 2019-08-02 |
| 1528538170 | Angel Laamber Adams | Nurse Practitioner | 7777 Forest Lane Suite C 833, Dallas, TX 75230 | 2018-11-27 |
| 1538634399 | Tochukwu Chioma Uche-ukah | Nurse Practitioner | Dr Katari, Encompass Health Rehabilitations, 7930 Northaven Rd, Dallas, TX 75230 | 2018-10-09 |
| 1790260958 | Ability Aba, Pllc | Behavioral Analyst | 5930 Royal Lane Ste E, #301, Dallas, TX 75230 | 2018-10-03 |
| 1750887956 | Brandi Nicole Freeman | Behavioral Analyst | 5639 Mcshann Rd, Dallas, TX 75230 | 2018-04-05 |
| 1326547720 | Whitney A Stewart | Psychologist | 5924 Royal Lane, Ste 258, Preston Hollow Health & Wellness, Dallas, TX 75230 | 2018-02-12 |
| 1407384373 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7859 Walnut Hill Ln Ste 110, Dallas, TX 75230 | 2017-05-23 |
| 1215488648 | The Walker Wellness Clinic | Community/Behavioral Health | 12200 Preston Rd., Dallas, TX 75230 | 2016-10-20 |
| 1578912325 | Renat Kudyakov | Nurse Practitioner | 7777 Forest Ln Ste B-446, Dallas, TX 75230 | 2016-06-11 |
| 1407210982 | Rohan Venugopal Menon | Pediatrics | 7777 Forest Lane, Bldg B 300, Dallas, TX 75230 | 2016-04-11 |
| Find all providers in zip 75230 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831798875 | Btdi Jv, LLP | Physiological Laboratory | 712 N Washington Ave Ste 102, Dallas, TX 75246-2604 | 2020-10-21 |
| 1033746540 | Enovatemed Solutions, LLC | Physiological Laboratory | 18006 Hillcrest Rd, Dallas, TX 75252-5862 | 2020-03-25 |
| 1205475829 | Intraoperative Neuro Professionals | Physiological Laboratory | 25 Highland Park Vlg # 100-470, Dallas, TX 75205-2789 | 2019-12-30 |
| 1881237568 | Mbb Management | Physiological Laboratory | 12700 Hillcrest Rd Ste 158, Dallas, TX 75230-2055 | 2019-10-24 |
| 1730738386 | Foj Neuro Diagnostics LLC | Physiological Laboratory | 13421 Tangleridge Ln, Dallas, TX 75240-5342 | 2019-09-06 |
| 1780196576 | Progressive Neuro Diagnostics | Physiological Laboratory | 350 N Saint Paul St Apt 2114, Dallas, TX 75201-4220 | 2017-11-01 |
| 1588981831 | Pro-tech-tive Neuromonitoring, LLC | Physiological Laboratory | 10114 Pinecrest Dr, Dallas, TX 75228-3257 | 2010-04-27 |
| 1144550369 | Health Imaging Partners LLC | Physiological Laboratory | 12201 Merit Dr Ste 100, Dallas, TX 75251-2122 | 2010-01-11 |
| 1144340258 | Digitrace Care Services Inc | Physiological Laboratory | 8700 N Stemmons Fwy, Suite 135, Dallas, TX 75247-3729 | 2007-03-30 |
| 1972512994 | Innerface Imaging LLC | Physiological Laboratory | 10100 N Central Expressway, Ste 100, Dallas, TX 75231 | 2006-08-07 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.