NPI 1306486394

Brainwave Neurodiagnostics LLC

Organisation Physiological Laboratory McKinney, TX

Practice location

Address: 4541 Medical Center Dr, McKinney, TX 75069-1651
Phone: (214) 686-9393
Mailing address: 304 S Coppell Rd, Coppell, TX 75019-2417

Authorised official

Name: Nibu Malaickal
Title: Owner
Phone: (214) 686-9393

Registered specialties

Physiological Laboratory Primary

Laboratories Taxonomy 293D00000X

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Registry record

NPI: 1306486394
Entity type: Organization
NPI issued: 8 Jan 2020
Record last updated: 8 Jan 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.