SOURCE 1 MEDICAL INC NPI 1457016966

NPI Information

NPI: 1457016966
Provider Name: SOURCE 1 MEDICAL INC
Classification: Psychiatry & Neurology - 2084N0600X
Entity Type: Organization

Specialization: Clinical Neurophysiology

Address:
5425 W SPRING CREEK PKWY STE 270
PLANO, TX
ZIP 75024
Phone: (972) 801-2190
Get Directions

SOURCE 1 MEDICAL INC is a clinical neurophysiology psychiatry neurology in Plano, TX. The provider is clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). SOURCE 1 MEDICAL INC NPI is 1457016966. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5425 W SPRING CREEK PKWY STE 270
PLANO, TX
ZIP 75024-317
Phone: (972) 801-2190
Fax: (972) 801-2191

The provider's authorized official is William Garret Harrell .
The authorized official title is Chief Operations Officer and has the following contact phone number (214) 808-2724.

The enumeration date for this NPI number is 11/1/2021 and was last updated on 3/24/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	204R00000X	Electrodiagnostic Medicine		No
2	2084N0400X	Psychiatry & Neurology	Neurology	No
3	225100000X	Physical Therapist		No
4	2251E1300X	Physical Therapist	Electrophysiology, Clinical	No
5	2251S0007X	Physical Therapist	Sports	No
6	2251X0800X	Physical Therapist	Orthopedic	No
7	225X00000X	Occupational Therapist		No
8	225XN1300X	Occupational Therapist	Neurorehabilitation	No
9	225XP0019X	Occupational Therapist	Physical Rehabilitation	No
10	246ZE0600X	Specialist/Technologist, Other	Electroneurodiagnostic	No
11	2084N0600X	Psychiatry & Neurology	Clinical Neurophysiology	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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