TONYA LANNETTE JACK


Address: 2000 E Lamar Blvd Ste 608, Arlington, TX 76006-7346
Phone: 4052861016

TONYA LANNETTE JACK (NPI# 1902455330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1902455330
Entity Type Individual
Full Name TONYA LANNETTE JACK
Other Name TONYA LANNETTE MASON
Practice Address 2000 E Lamar Blvd Ste 608
Arlington
TX 76006-7346
Mailing Address 11900 N Macarthur Blvd Ste E2
Oklahoma City
OK 73162-1859
Practice Telephone 4052861016
Practice Fax Number 4052421016
Mailing Telephone 4054652086
Mailing Fax Number 4052421016
Enumeration Date 2019-09-09
Last Update Date 2019-09-09
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 246ZE0500X Specialist/Technologist, Other
Specialization: EEG
Technologists, Technicians & Other Technical Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
OK 1255736724 05
MO 1376923367 05
CO 1265803829 05

Office Location

Street Address 2000 E LAMAR BLVD STE 608
City ARLINGTON
State TX
Zip Code 76006-7346

Providers in the same location

NPI Name Taxonomy Address Enumeration
1851940209 Neurodiagnostics Services Southwest Specialist/Technologist, Other 2000 E Lamar Blvd Ste 608, Arlington, TX 76006-7346 2019-09-09

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NPI Name Taxonomy Address Enumeration
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1033635636 Genxmed LLC Durable Medical Equipment & Medical Supplies 2221 E Lamar, Suite 900, Arlington, TX 76006 2017-08-16
1225558521 Jessica Joanne Salas-figueroa Specialist/Technologist 36 Los Robles St, Arlington, TX 76006 2017-06-27
1851771372 Donald Thomas Jr. Pharmacist 1221 Corporate Dr, Arlington, TX 76006 2015-06-01
1083093074 Jerry Moore Pharmacist 1221 Corporate Drive East, Arlington, TX 76006 2015-05-22
1104212794 Aac Dallas Outpatient Center, LLC Clinic/Center 2301 Avenue J, Arlington, TX 76006 2015-04-09
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Taxonomy Information

Taxonomy Code 246ZE0500X
Grouping Technologists, Technicians & Other Technical Service Providers
Classification Specialist/Technologist, Other
Specialization EEG

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1073936993 Dariush Alirezaieyan Specialist/Technologist, Other 6601 Johns Crt, Arlington, TX 76016 2014-01-29
1851940209 Neurodiagnostics Services Southwest Specialist/Technologist, Other 2000 E Lamar Blvd Ste 608, Arlington, TX 76006-7346 2019-09-09

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1831724798 Optimum Iom Tech, LLC Specialist/Technologist, Other 3526 Lakeview Pkwy # B132, Rowlett, TX 75088-4176 2020-03-10
1386287159 Pulse Diagnostic Services,llc Specialist/Technologist, Other 17434 Red Oak Dr, Houston, TX 77090-1246 2019-10-23
1588122436 Katrina Reichardt Specialist/Technologist, Other 3308 Ella Blvd Ste L, Houston, TX 77018-7336 2019-03-11
1578033254 Nibu Jacob Malaickal Specialist/Technologist, Other 304 S Coppell Rd, Coppell, TX 75019-2417 2018-11-26
1750867123 Icon Neuromonitoring, LLC Specialist/Technologist, Other 23742 Ardmore Cove Dr, Spring, TX 77386-4255 2018-07-18
1720571854 Poly-rhythms Specialist/Technologist, Other 2531 Copper Fields Dr, Rosharon, TX 77583-3273 2018-06-13
1629584552 Amb Eeg LLC Specialist/Technologist, Other 1100 Glade Rd Ste 2, Colleyville, TX 76034-4227 2017-12-14
1639683212 H&p Diagnostic Services LLC Specialist/Technologist, Other 310 E Interstate 30 Ste M105, Garland, TX 75043 2017-11-19
1972015089 Caroline Cowles Collins Specialist/Technologist, Other 25 Highland Park Vlg # 100-225, Dallas, TX 75205-2789 2017-10-30
1306363114 Celeste Ann Parker Specialist/Technologist, Other 70 Mission Dr, New Braunfels, TX 78130-6659 2017-08-23
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Competitor

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City ARLINGTON
Zip Code 76006

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Dataset Information

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.

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