Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southlake Neuromonitoring LLC

Organization Electrodiagnostic Medicine Physician · NPI 1982172987

Southlake Neuromonitoring LLC is an Electrodiagnostic Medicine Physician in Ft Worth, Texas. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

111 Boland St Ste 211
Ft Worth, TX 76107-1265
Phone: (214) 269-3875
Fax: (903) 328-6568
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Electrodiagnostic Medicine Physician (primary) Taxonomy 204R00000X

Record details

NPI number1982172987
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gina Sullivan — Billing Manager · (214) 269-3875
NPI enumeratedNovember 7, 2018
Last updated in NPPESNovember 7, 2018
Mailing address111 Boland St Ste 211, Ft Worth, TX 76107-1265

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