PHYSIOLOGIC DIAGNOSTIC SERVICE, LLC (NPI# 1669818563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669818563 |
| Entity Type | Organization |
| Organization Name | PHYSIOLOGIC DIAGNOSTIC SERVICE, LLC |
| Practice Address |
4347 W Northwest Hwy Ste 130 #313 Dallas TX 75220-3866 |
| Practice Telephone | 4692831988 |
| Practice Fax Number | 2105661330 |
| Mailing Telephone | (469) 283-1988 |
| Mailing Fax Number | 2105661330 |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2017-08-24 |
| Authorized Official Name | LIZETTE MORIN (MDMS NPI COMPLIANCE OFFICER) |
| Authorized Official Telephone | 2105982801 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
4347 W NORTHWEST HWY STE 130 #313 |
| City | DALLAS |
| State | TX |
| Zip Code | 75220-3866 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477692523 | Monarch Medical | Durable Medical Equipment & Medical Supplies | 4347 W Northwest Hwy, # 120-206, Dallas, TX 75220-3864 | 2007-02-05 |
| 1366818585 | Jacob Landers | Physical Therapist | 4347 W Northwest Hwy, Dallas, TX 75220-3864 | 2015-08-12 |
| 1609253814 | Marika Crockett | Physical Therapist | 4347 W Northwest Hwy, Dallas, TX 75220-3864 | 2015-04-27 |
| 1992192512 | Baylor Institute for Rehabilitation | Rehabilitation Hospital | 4347 W Northwest Hwy, Suite 180, Dallas, TX 75220-3864 | 2015-04-21 |
| 1710281480 | Bruce Wesley Buirkle | Counselor | 4347 W Northwest Hwy, # 120-162, Dallas, TX 75220-3864 | 2011-01-10 |
| 1255652129 | Chase Mykel Hamilton | Physical Therapist | 4347 W Northwest Hwy, Suite 180, Dallas, TX 75220-3864 | 2010-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314736 | Maritza Garcia | Counselor | 3850 W Nothwest Hwy, #3004, Dallas, TX 75220 | 2020-07-28 |
| 1205379807 | Belamour Home Care | Home Health | 9711 Dale Crest Dr. #231, Dallas, TX 75220 | 2016-11-30 |
| 1760828404 | Chrisbibi Homehealth Agency Inc | Nursing Care | 2514 Community Dr Suite 107, Dallas, TX 75220 | 2013-05-21 |
| 1841540697 | Suzanne Eades | Psychologist | 9407 Midway Road, Dallas, TX 75220 | 2012-09-19 |
| 1215210141 | Susan Pham | Pharmacist | 3732 W. Northwest Hwy, Dallas, TX 75220 | 2011-09-27 |
| 1740507573 | Mifamilia Medical, Pllc | General Practice | 2445 W Northwest Hwy 105, Dallas, TX 75220 | 2010-05-04 |
| 1306173273 | Kevin Khoi Nguyen | Pharmacist | 3732 W Northwest Highway, Dallas, TX 75220 | 2009-11-12 |
| 1154554434 | Amanda L Carlile | Nurse Practitioner | 3978 Beechwood Ln, Dallas, TX 75220 | 2009-09-02 |
| 1417180373 | Lauri Ruth Jacoby-greenberg | Speech-Language Pathologist | 9741 Meadowbrook Dr., Dallas, TX 75220 | 2009-08-26 |
| 1114164480 | Hamid Reza Kashani Madjd | Dentist | 3701 W Northwest Highway, Suite # 306, Dallas, TX 75220 | 2009-01-08 |
| Find all providers in zip 75220 | ||||
| Taxonomy Code | 246ZE0600X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Electroneurodiagnostic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124667746 | Applied Intraoperative Care Technology | Specialist/Technologist, Other | 25 Highland Park Vlg # 100-469, Dallas, TX 75205-2789 | 2019-12-30 |
| 1366975450 | Kaitlyn Friese | Specialist/Technologist, Other | 5339 Alpha Rd Ste 450, Dallas, TX 75240-7306 | 2017-04-06 |
| 1275985277 | Physicians Interest, Lp | Specialist/Technologist, Other | 6125 Luther Ln # 175, Dallas, TX 75225-6202 | 2016-07-01 |
| 1588039788 | Douglas Yang | Specialist/Technologist, Other | 4849 Greenville Ave Ste 1125, Dallas, TX 75206-4155 | 2015-12-14 |
| 1003200544 | Jamie Rebekah Pearson | Specialist/Technologist, Other | 6437 South Point Dr., Dallas, TX 75248 | 2015-03-23 |
| 1205228293 | Samira Naim | Specialist/Technologist, Other | 3100 Monticello Ave Ste 210, Dallas, TX 75205-3442 | 2015-02-27 |
| 1639578123 | Adam Martin | Specialist/Technologist, Other | 3001 Monticello, 210, Dallas, TX 75205 | 2014-08-20 |
| 1235541509 | Revolution Monitoring | Specialist/Technologist, Other | 6437 Southpoint Dr, Dallas, TX 75248-2109 | 2014-05-21 |
| 1376884023 | Joseph Sangillo | Specialist/Technologist, Other | 17717 Vail St, Apt 1316, Dallas, TX 75287-6400 | 2013-03-05 |
| 1851657308 | Pinnacle Diagnostics, Pllc | Specialist/Technologist, Other | 6119 Greenville Avenue, #358, Dallas, TX 75206 | 2012-04-10 |
| 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.