Provider Demographics
NPI:1609433366
Name:US EEG, LLC
Entity type:Organization
Organization Name:US EEG, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:W
Authorized Official - Last Name:JOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-415-7659
Mailing Address - Street 1:111 BOLAND ST STE 211
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-1265
Mailing Address - Country:US
Mailing Address - Phone:814-529-8500
Mailing Address - Fax:520-335-8705
Practice Address - Street 1:3100 MONTICELLO AVE STE 210
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-3442
Practice Address - Country:US
Practice Address - Phone:817-529-8500
Practice Address - Fax:520-335-8705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-28
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory