Provider Demographics
NPI:1467129387
Name:COMMONS IOM TECH, LLC
Entity Type:Organization
Organization Name:COMMONS IOM TECH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-378-5422
Mailing Address - Street 1:13236 N. 7TH ST.
Mailing Address - Street 2:SUITE 4 #289
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022
Mailing Address - Country:US
Mailing Address - Phone:832-871-4609
Mailing Address - Fax:832-871-4609
Practice Address - Street 1:3115 COLLEGE PARK DR STE 101B
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-4001
Practice Address - Country:US
Practice Address - Phone:832-871-4609
Practice Address - Fax:832-871-4609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty