Provider Demographics
NPI:1467758052
Name:NEUROINTEGRITY DIAGNOSTICS, P.A.
Entity Type:Organization
Organization Name:NEUROINTEGRITY DIAGNOSTICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:832-912-8603
Mailing Address - Street 1:12337 JONES RD.
Mailing Address - Street 2:SUITE 427
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4951
Mailing Address - Country:US
Mailing Address - Phone:832-912-8603
Mailing Address - Fax:832-912-8616
Practice Address - Street 1:12337 JONES RD
Practice Address - Street 2:SUITE 427
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4800
Practice Address - Country:US
Practice Address - Phone:832-912-8603
Practice Address - Fax:832-912-8616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0125246ZE0500X, 246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEGGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX342001Medicare Oscar/Certification