Provider Demographics
NPI:1801227814
Name:NEURO ANALYSIS DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:NEURO ANALYSIS DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:CARLTON
Authorized Official - Last Name:ALDRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:BS, RRT
Authorized Official - Phone:832-362-7875
Mailing Address - Street 1:20403 UNIVERSITY BLVD
Mailing Address - Street 2:STE. 300
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4976
Mailing Address - Country:US
Mailing Address - Phone:832-362-7875
Mailing Address - Fax:832-365-6065
Practice Address - Street 1:2825 W TOWN CENTER CIR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3734
Practice Address - Country:US
Practice Address - Phone:281-302-5983
Practice Address - Fax:832-365-6065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FTS255Medicare PIN