Provider Demographics
NPI:1659402568
Name:NEUROTECHS DIAGNOSTIC SERVICES LLC
Entity Type:Organization
Organization Name:NEUROTECHS DIAGNOSTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ETHAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LAUER
Authorized Official - Suffix:
Authorized Official - Credentials:R NCS T
Authorized Official - Phone:713-861-4744
Mailing Address - Street 1:PO BOX 542069
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77254-2069
Mailing Address - Country:US
Mailing Address - Phone:713-861-4744
Mailing Address - Fax:866-393-3765
Practice Address - Street 1:5900 MEMORIAL DR STE 214
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-8004
Practice Address - Country:US
Practice Address - Phone:713-861-4744
Practice Address - Fax:866-393-3765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty