Provider Demographics
NPI:1376218396
Name:MOBILE EEG TESTING INC
Entity type:Organization
Organization Name:MOBILE EEG TESTING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAHNAZ
Authorized Official - Middle Name:J
Authorized Official - Last Name:DARVISHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-405-7582
Mailing Address - Street 1:4101 W GREEN OAKS BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-6800
Mailing Address - Country:US
Mailing Address - Phone:800-323-1771
Mailing Address - Fax:817-483-4068
Practice Address - Street 1:1420 N COOPER ST STE 110
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-8530
Practice Address - Country:US
Practice Address - Phone:800-323-1771
Practice Address - Fax:817-483-4068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-11
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic