BRAINWAVE NEURODIAGNOSTICS LLC (NPI# 1306486394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306486394 |
| Entity Type | Organization |
| Organization Name | BRAINWAVE NEURODIAGNOSTICS LLC |
| Practice Address |
4541 Medical Center Dr Mckinney TX 75069-1651 |
| Mailing Address |
304 S Coppell Rd Coppell TX 75019-2417 |
| Practice Telephone | 2146869393 |
| Mailing Telephone | 2146869393 |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2020-01-08 |
| Authorized Official Name | NIBU MALAICKAL (OWNER) |
| Authorized Official Telephone | 2146869393 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| Street Address |
4541 MEDICAL CENTER DR |
| City | MCKINNEY |
| State | TX |
| Zip Code | 75069-1651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407273675 | Meghan Richards | Nurse Practitioner | 4541 Medical Center Dr, Mckinney, TX 75069-1651 | 2014-03-25 |
| 1477899953 | Ruwani Walgama | Dietitian, Registered | 4541 Medical Center Dr, Mckinney, TX 75069-1651 | 2013-01-02 |
| 1326139346 | Tracey L Collins | Nurse Practitioner | 4541 Medical Center Dr, Mckinney, TX 75069-1651 | 2006-09-27 |
| 1588699334 | Julie A Charlton | Advanced Practice Midwife | 4541 Medical Center Dr, Mckinney, TX 75069-1651 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026029 | Tiffany Lynn Lowery | Family Medicine | 103 East Lamar St, Mckinney, TX 75069 | 2020-09-06 |
| 1689285603 | Heather Nicole Hester | Social Worker | 4601 Medical Drive Ste F, Mckinney, TX 75069 | 2020-08-13 |
| 1114552916 | Wonderfully Made Wellness Sanctuary | Nurse Practitioner | 105 S. Tennessee Street Suite 102, Mckinney, TX 75069 | 2020-03-12 |
| 1477030385 | Kristyn Lowe | Licensed Vocational Nurse | 110 E Louisiana, Suite 201-amp, Mckinney, TX 75069 | 2018-07-24 |
| 1710464631 | Shasta Massey | Registered Nurse | 110 E Louisinana, Suite 201-amp, Mckinney, TX 75069 | 2018-07-24 |
| 1215414149 | Allison Marion | Registered Nurse | 110 E Louisiana St, Suite 201-amp, Mckinney, TX 75069 | 2018-07-24 |
| 1497273759 | Kim C. Carson | Counselor | 201 W. Virginia Suite 203, Mckinney, TX 75069 | 2017-09-06 |
| 1629596283 | Christy Lynne Billings | Counselor | 101 W. Louisiana St. Suite # 208, Mckinney, TX 75069 | 2017-09-05 |
| 1932623626 | Lauren Broadbent | Speech-Language Pathologist | 265 Plateau Drive, Mckinney, TX 75069 | 2017-08-03 |
| 1932623147 | Lindsey Ann Gillespie | Nurse Practitioner | 4561 Medical Center Drive, Mckinney, TX 75069 | 2017-07-29 |
| Find all providers in zip 75069 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528507795 | Neuline Health Management LLC | Physiological Laboratory | 1402 S Custer Rd Ste 302, Mckinney, TX 75072-1452 | 2017-02-21 |
| 1215359401 | Health Imaging Partners LLC | Physiological Laboratory | 1800 N Lake Forest Drive, Suite 100, Mckinney, TX 75071 | 2014-01-08 |
| 1932547460 | Btdi Jv LLP | Physiological Laboratory | 5321 W University Dr, Mckinney, TX 75071-7824 | 2013-06-06 |
| 1063076883 | Neuline Diagnostics LLC | Physiological Laboratory | 1402 S Custer Rd Ste 302, Mckinney, TX 75072-1452 | 2019-04-26 |
| 1710487186 | Pratik LLC | Physiological Laboratory | 11717 Beckton St, Mckinney, TX 75071-6902 | 2018-02-13 |
| 1144423914 | Overnight Sleep Analysis, LLC | Physiological Laboratory | 2760 Virginia Pkwy Ste 200, Mckinney, TX 75071-4964 | 2007-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457952574 | Neurodiagnostics and Imaging LLC | Physiological Laboratory | 2024 W 15th St Ste F-352, Plano, TX 75075-7363 | 2020-11-04 |
| 1831798875 | Btdi Jv, LLP | Physiological Laboratory | 712 N Washington Ave Ste 102, Dallas, TX 75246-2604 | 2020-10-21 |
| 1194334144 | Sonji M Blanchard | Physiological Laboratory | 8553 N Beach St Ste 224, Fort Worth, TX 76244-4919 | 2020-07-27 |
| 1639797863 | Lab Testing Near Me LLC | Physiological Laboratory | 2706 Wind Point Ct, Tolar, TX 76476-5077 | 2020-07-14 |
| 1871121004 | St. Anthony's Diagnostic Pllc | Physiological Laboratory | 3931 Joe Ramsey Blvd E Ste A, Greenville, TX 75401-7777 | 2020-04-01 |
| 1033746540 | Enovatemed Solutions, LLC | Physiological Laboratory | 18006 Hillcrest Rd, Dallas, TX 75252-5862 | 2020-03-25 |
| 1437799913 | Valmar, Plc | Physiological Laboratory | 7905 Bentley Dr, North Richland Hills, TX 76182-7683 | 2020-01-13 |
| 1205475829 | Intraoperative Neuro Professionals | Physiological Laboratory | 25 Highland Park Vlg # 100-470, Dallas, TX 75205-2789 | 2019-12-30 |
| 1437797610 | Guard Healthcare Systems LLC | Physiological Laboratory | 2261 Brookhollow Plaza Dr Ste 307, Arlington, TX 76006-7430 | 2019-12-18 |
| 1932745940 | Magdouhealth LLC | Physiological Laboratory | 205 N Green St, Grand Saline, TX 75140-1829 | 2019-11-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.