Provider Demographics
NPI:1265289482
Name:CENTRAL NEUROMONITORING SERVICES
Entity type:Organization
Organization Name:CENTRAL NEUROMONITORING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEURO-DIAGNOSTIC TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:SIBILLE
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM
Authorized Official - Phone:337-781-6959
Mailing Address - Street 1:3526 LAKEVIEW PKWY STE B202
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-4176
Mailing Address - Country:US
Mailing Address - Phone:972-412-5299
Mailing Address - Fax:469-453-3374
Practice Address - Street 1:101 STEVE ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-6047
Practice Address - Country:US
Practice Address - Phone:337-781-6959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty