Four States Neuro Tech, PA

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

Legal business name

FOUR STATES NEURO TECH, PA

Practice address

4516 Lovers LN # 331
Dallas, TX 75225-6925

Phone

(214) 675-0905

Fax

(214) 317-4888

NPI assigned

Jul 6, 2012

Last updated

Jul 6, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Trase Mahan

Title

Manager

Phone

(214) 675-0905

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341532800000",
    "number": "1174888184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 702620",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741702620",
            "telephone_number": "214-675-0905",
            "fax_number": "214-317-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 LOVERS LN # 331",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752256925",
            "telephone_number": "214-675-0905",
            "fax_number": "214-317-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR STATES NEURO TECH, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-06",
        "last_updated": "2012-07-06",
        "status": "A",
        "authorized_official_last_name": "MAHAN",
        "authorized_official_first_name": "TRASE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "214-675-0905"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Foundationplus
• Founders Healthcare, LLC (Preferred Homecare)
• Cynthia Lynette Fountain, SLP
• Joshua Dean Fountain, DDS
• Fountains Home Healthcare, Inc
• Four-N Dental, PLLC (Lochwood Family Dental, Cooper Family Dental)
• Brooke Alexa Fourcade
• Hayley Fournier, PHD
• Fourth Dimension Orthodontics & Craniofacial Orthopedics
• Kimber Lee Foust, MD

• Surgical Technologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Surgical Technologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2012; 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.