Active NPI
US Eeg, LLC
- Physiological Laboratory
- Dallas, TX
National Provider Identifier
1609433366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physiological Laboratory
- Legal business name
- US EEG, LLC
- Practice address
- 3100 Monticello Ave Ste 210
Dallas, TX 75205-3442 - Phone
- (817) 529-8500
- Fax
- (520) 335-8705
- NPI assigned
- May 28, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Gary W Joe
- Title
- Partner
- Phone
- (214) 415-7659
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physiological Laboratory | 293D00000X | Primary |
Addresses
Primary practice location
3100 Monticello Ave Ste 210
Dallas, TX 75205-3442
Mailing address
111 Boland St Ste 211
Fort Worth, TX 76107-1265
Phone (814) 529-8500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200420001870 | TX | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 1759711500 | Practice locations: Dallas, TX |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Neurology Physician
- Dallas, TX
- NPI 1649598285
-
- Neurology Physician
- Atlanta, GA
- NPI 1831695329
-
- Neurology Physician
- Atlanta, GA
- NPI 1326022583
-
- Neurological Surgery Physician
- Grove, OK
- NPI 1669465811
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559001600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1730851200000",
"number": "1609433366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 BOLAND ST STE 211",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761071265",
"telephone_number": "814-529-8500",
"fax_number": "520-335-8705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 MONTICELLO AVE STE 210",
"city": "DALLAS",
"state": "TX",
"postal_code": "752053442",
"telephone_number": "817-529-8500",
"fax_number": "520-335-8705"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "US EEG, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-05-28",
"last_updated": "2024-11-06",
"certification_date": "2024-11-06",
"status": "A",
"authorized_official_last_name": "JOE",
"authorized_official_first_name": "GARY",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "214-415-7659",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "293D00000X",
"taxonomy_group": "",
"desc": "Physiological Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.