Organization Active NPI

Dell Diagnostics LLC

  • Electroneurodiagnostic Specialist/Technologist
  • Fort Worth, TX
National Provider Identifier
1689142275
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X
Legal business name
DELL DIAGNOSTICS LLC
Practice address
111 Boland St Ste 211
Ft Worth, TX 76107-1265
Phone
(214) 269-3875
Fax
(903) 328-6568
NPI assigned
Nov 13, 2018
Last updated
Nov 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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

Authorized official

Name
Gina Sullivan
Title
Billing Manager
Phone
(214) 269-3875

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/Technologist 246ZE0600X Primary

Addresses

Primary practice location

111 Boland St Ste 211
Ft Worth, TX 76107-1265

Mailing address

111 Boland St Ste 211
Ft Worth, TX 76107-1265

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1689142275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BOLAND ST STE 211",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761071265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BOLAND ST STE 211",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761071265",
            "telephone_number": "214-269-3875",
            "fax_number": "903-328-6568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELL DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "214-269-3875"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.