OMNI EEG LAB, INC. (NPI# 1366735771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366735771 |
| Entity Type | Organization |
| Organization Name | OMNI EEG LAB, INC. |
| Practice Address |
6162 E Mockingbird Ln Suite 210a Dallas TX 75214-2697 |
| Practice Telephone | 8773345227 |
| Practice Fax Number | 2145508215 |
| Mailing Telephone | 8773345227 |
| Mailing Fax Number | 2145508215 |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2011-05-17 |
| Authorized Official Name | JULIAN TILLEMAN (PRESIDENT) |
| Authorized Official Telephone | 8773345227 |
| Authorized Official Credential | R. EEG T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| Street Address |
6162 E MOCKINGBIRD LN SUITE 210A |
| City | DALLAS |
| State | TX |
| Zip Code | 75214-2697 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215926936 | Nancy Lee Sonntag | Social Worker | 6162 E Mockingbird Ln, Ste. 215, Dallas, TX 75214-2697 | 2005-10-14 |
| 1265942056 | Tanasha N Friar | Massage Therapist | 6162 E Mockingbird Ln, Dallas, TX 75214-2697 | 2017-10-05 |
| 1780045260 | Lakewood Dermatology, Pllc | Dermatology | 6162 E Mockingbird Ln, Ste. 120, Dallas, TX 75214-2697 | 2016-03-11 |
| 1710231824 | Davisson Consulting, Inc. | Counselor | 6162 E Mockingbird Ln, 220, Dallas, TX 75214-2697 | 2012-10-29 |
| 1023374519 | Patrick Henry Mcdonough | Dermatology | 6162 E Mockingbird Ln, Suite 120, Dallas, TX 75214-2697 | 2012-04-09 |
| 1346454766 | Edward A. Davisson | Counselor | 6162 E Mockingbird Ln, 220, Dallas, TX 75214-2697 | 2007-05-09 |
| 1447379821 | Joe Reed Campbell | Massage Therapist | 6162 E Mockingbird Ln, Suite 205, Dallas, TX 75214-2697 | 2007-03-28 |
| 1194841940 | Julien Porter Devereux | Social Worker | 6162 E Mockingbird Ln, Suite #215, Dallas, TX 75214-2697 | 2007-03-22 |
| 1427180710 | Beverly Ann Young | Counselor | 6162 E Mockingbird Ln, Suite 204, Dallas, TX 75214-2697 | 2007-03-12 |
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| 1487136776 | Muriel Kim Jimenez | Occupational Therapist | 6301 Gaston Ave # 162p, Dallas, TX 75214 | 2018-09-03 |
| 1447783352 | Nietta Reynolds | Counselor | 4935 Junius, 9, Dallas, TX 75214 | 2017-04-07 |
| 1124551536 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 6474 E. Northwest Hwy, Dallas, TX 75214 | 2017-04-04 |
| 1093265324 | Sarah Gammon | Behavior Technician | 6908 Wake Forrest Dr, Dallas, TX 75214 | 2016-10-11 |
| 1669921466 | Ivan Barboza | Physical Therapy Assistant | 5931 Reiger Ave, Dallas, TX 75214 | 2016-09-22 |
| 1164892857 | Edwin Gulledge Grafton Jr. | Ophthalmology | 6235 Ravendale Ln., Dallas, TX 75214 | 2015-10-07 |
| 1093182057 | Callie Jack | Audiologist-Hearing Aid Fitter | 6162 E. Mockingbird Lane, Suite 100, Dallas, TX 75214 | 2015-08-26 |
| 1427436179 | John Martin Whitfill | Internal Medicine | 7040 Tokalon Dr., Dallas, TX 75214 | 2015-05-14 |
| Find all providers in zip 75214 | ||||
| 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. |
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| 1588981831 | Pro-tech-tive Neuromonitoring, LLC | Physiological Laboratory | 10114 Pinecrest Dr, Dallas, TX 75228-3257 | 2010-04-27 |
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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.