Provider Demographics
NPI:1841032109
Name:THE BRAIN ARTISAN LLC
Entity type:Organization
Organization Name:THE BRAIN ARTISAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:ROST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-786-7932
Mailing Address - Street 1:15310 PENN HILLS LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-3529
Mailing Address - Country:US
Mailing Address - Phone:281-786-7932
Mailing Address - Fax:
Practice Address - Street 1:1120 NASA PKWY STE 220B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3342
Practice Address - Country:US
Practice Address - Phone:832-271-4664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-08
Last Update Date:2024-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEGGroup - Single Specialty