Provider Demographics
NPI:1790457752
Name:ADVANCED NEUROMONITORING SERVICES PLLC
Entity Type:Organization
Organization Name:ADVANCED NEUROMONITORING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGNUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-378-6908
Mailing Address - Street 1:6160 WINDHAVEN PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-2138
Mailing Address - Country:US
Mailing Address - Phone:197-237-8690
Mailing Address - Fax:
Practice Address - Street 1:6160 WINDHAVEN PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-2138
Practice Address - Country:US
Practice Address - Phone:197-237-8690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUIS A MIGNUCCI, MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Single Specialty