Provider Demographics
NPI:1376922815
Name:KC NEUROMONITORING, LLC
Entity Type:Organization
Organization Name:KC NEUROMONITORING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUDAN
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM
Authorized Official - Phone:832-729-0197
Mailing Address - Street 1:32515 WESTWOOD SQUARE EAST DR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-3441
Mailing Address - Country:US
Mailing Address - Phone:832-729-0197
Mailing Address - Fax:936-570-0231
Practice Address - Street 1:32515 WESTWOOD SQUARE EAST DR
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-3441
Practice Address - Country:US
Practice Address - Phone:832-729-0197
Practice Address - Fax:936-570-0231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty