Provider Demographics
NPI: | 1699002998 |
---|---|
Name: | NEUROTECHS PR, LLC |
Entity type: | Organization |
Organization Name: | NEUROTECHS PR, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | ANGELIA |
Authorized Official - Middle Name: | D |
Authorized Official - Last Name: | KOLENDA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 832-380-3626 |
Mailing Address - Street 1: | PO BOX 542069 |
Mailing Address - Street 2: | |
Mailing Address - City: | HOUSTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77254-2069 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 832-380-3626 |
Mailing Address - Fax: | 866-681-8706 |
Practice Address - Street 1: | 5900 MEMORIAL DR STE 215 |
Practice Address - Street 2: | |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77007-8030 |
Practice Address - Country: | US |
Practice Address - Phone: | 832-380-3626 |
Practice Address - Fax: | 866-681-8706 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-11-06 |
Last Update Date: | 2009-11-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 246ZE0600X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Electroneurodiagnostic | Group - Multi-Specialty |