Provider Demographics
NPI:1861976169
Name:NOBLE NEURODIAGNOSTIC SERVICES, LLC
Entity type:Organization
Organization Name:NOBLE NEURODIAGNOSTIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANGULLIE
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM
Authorized Official - Phone:713-865-0730
Mailing Address - Street 1:205 CALCASIEU XING
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-7873
Mailing Address - Country:US
Mailing Address - Phone:337-366-7535
Mailing Address - Fax:713-893-6967
Practice Address - Street 1:205 CALCASIEU XING
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-7873
Practice Address - Country:US
Practice Address - Phone:337-366-7535
Practice Address - Fax:713-893-6967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty