Provider Demographics
NPI:1851712103
Name:CLINICAL NEURO MONITORING SPECIALIST,LLC
Entity Type:Organization
Organization Name:CLINICAL NEURO MONITORING SPECIALIST,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VICTORIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-581-6950
Mailing Address - Street 1:9301 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 355
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1510
Mailing Address - Country:US
Mailing Address - Phone:713-581-6950
Mailing Address - Fax:713-581-6951
Practice Address - Street 1:9301 SOUTHWEST FWY
Practice Address - Street 2:SUITE 355
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1510
Practice Address - Country:US
Practice Address - Phone:713-581-6950
Practice Address - Fax:713-581-6951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty