Provider Demographics
NPI:1629862776
Name:GONEURO IOM LLC
Entity type:Organization
Organization Name:GONEURO IOM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNIM
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:DOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-353-4425
Mailing Address - Street 1:9205 EAGLE DR STE 300-451
Mailing Address - Street 2:
Mailing Address - City:MONT BELVIEU
Mailing Address - State:TX
Mailing Address - Zip Code:77523-5618
Mailing Address - Country:US
Mailing Address - Phone:713-353-4425
Mailing Address - Fax:
Practice Address - Street 1:730 NORTH LOOP STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-1043
Practice Address - Country:US
Practice Address - Phone:713-353-4425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-05
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty