Provider Demographics
NPI:1215440664
Name:INTEGRITY NEUROMONITORING
Entity type:Organization
Organization Name:INTEGRITY NEUROMONITORING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:FANSELAU
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM
Authorized Official - Phone:972-489-6170
Mailing Address - Street 1:6437 SOUTHPOINT DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-2109
Mailing Address - Country:US
Mailing Address - Phone:214-228-1257
Mailing Address - Fax:469-385-8892
Practice Address - Street 1:6437 SOUTHPOINT DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-2109
Practice Address - Country:US
Practice Address - Phone:214-228-1257
Practice Address - Fax:469-385-8892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty