Provider Demographics
NPI:1689119075
Name:ARTEMIS INTRAOPERATIVE MONITORING LLC
Entity Type:Organization
Organization Name:ARTEMIS INTRAOPERATIVE MONITORING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOUTINAS
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM REP T
Authorized Official - Phone:469-226-8398
Mailing Address - Street 1:15305 DALLAS PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-6470
Mailing Address - Country:US
Mailing Address - Phone:214-810-3449
Mailing Address - Fax:972-476-0771
Practice Address - Street 1:15305 DALLAS PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-6470
Practice Address - Country:US
Practice Address - Phone:214-810-3449
Practice Address - Fax:972-476-0771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty