Provider Demographics
NPI:1144087354
Name:E-WAVE DIAGNOSTICS INCORPORATED
Entity type:Organization
Organization Name:E-WAVE DIAGNOSTICS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:CHAVERA
Authorized Official - Last Name:PUZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-744-9735
Mailing Address - Street 1:19214 NOAH ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-4130
Mailing Address - Country:US
Mailing Address - Phone:281-744-9735
Mailing Address - Fax:254-765-2754
Practice Address - Street 1:19214 NOAH ARBOR LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-4130
Practice Address - Country:US
Practice Address - Phone:281-744-9735
Practice Address - Fax:254-765-2754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEGGroup - Single Specialty