Global Brain Eeg, LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

GLOBAL BRAIN EEG, LLC

Practice address

521 W Southlake Blvd Ste 150
Southlake, TX 76092-6174

Phone

(817) 328-3000

Fax

(817) 328-3333

NPI assigned

Jan 31, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gary L Hollingsworth

Title

Ceo

Phone

(817) 328-3000

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1053859884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 W SOUTHLAKE BLVD STE 150",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926174",
            "telephone_number": "817-328-3000",
            "fax_number": "817-328-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 W SOUTHLAKE BLVD STE 150",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926174",
            "telephone_number": "817-328-3000",
            "fax_number": "817-328-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOBAL BRAIN EEG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-31",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "HOLLINGSWORTH",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-328-3000"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "409761001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Todd Allen Gjerdevig, LCSW
• Global Anesthesia Specialists, PLLC
• Global Brain Center Uddin PLLC
• Global Brain Center,LLC
• Global Brain Eeg
• Global Open Wound Care PLLC
• Melanie Lynn Gloede
• GMC Medical, PLLC
• Swapna Goday, MD
• Noah Godek

• Physiological Laboratory in Southlake, TX
• Providers in Southlake, TX by specialty
• Physiological Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.