Provider Demographics
NPI:1093013310
Name:AXIS NEUROMONITORING
Entity Type:Organization
Organization Name:AXIS NEUROMONITORING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TRAWEEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-344-2947
Mailing Address - Street 1:1819 JAY ELL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-1837
Mailing Address - Country:US
Mailing Address - Phone:888-344-2947
Mailing Address - Fax:888-694-2947
Practice Address - Street 1:1819 JAY ELL DR STE 100
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-1837
Practice Address - Country:US
Practice Address - Phone:888-344-2947
Practice Address - Fax:888-694-2947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-10
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX337550Medicare PIN