Centennial Neurodiagnostics Llc

LBN: Premier Diagnostics Llc
Centennial Neurodiagnostics Llc is an health care organization with primary practice located at 3838 Oak Lawn Ave Ste 1420 , Dallas TX 75219-4515. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Electrodiagnostic Medicine, Technologists, Technicians & Other Technical Service Providers / EEG, Laboratories / Physiological Laboratory. Laboratories / Physiological Laboratory is the primary health care specialty. Premier Diagnostics Llc can be contacted via phone (888) 482-2334, or through Weatherwax, Kenneth via phone (469) 646-8663.

Contact Information

Primary practice address
3838 Oak Lawn Ave Ste 1420 Dallas TX 75219-4515
Phone: (888) 482-2334
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Weatherwax, Kenneth
Phone: (469) 646-8663

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Electrodiagnostic Medicine 204R00000X
Technologists, Technicians & Other Technical Service Providers / EEG 246ZE0500X
Laboratories / Physiological Laboratory 293D00000X

Profile Details

NPI number 1528588795
LBN Legal business name Premier Diagnostics Llc
DBA Doing business as Centennial Neurodiagnostics Llc
Authorized official Weatherwax, Kenneth
Entity Organization
Organization subpart 1 No
Enumeration date Jun 20th, 2017
Last updated Jun 21st, 2024 - about 6 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528588795 NPPES
Texas MEDICAID 3875247
Texas MEDICAID 104480100

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