Provider Demographics
NPI:1881391449
Name:SUMMIT NEUROGUARD, LLC
Entity type:Organization
Organization Name:SUMMIT NEUROGUARD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:CARDONA
Authorized Official - Last Name:ROMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-583-7452
Mailing Address - Street 1:12022 BLUE VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-2647
Mailing Address - Country:US
Mailing Address - Phone:833-957-0797
Mailing Address - Fax:
Practice Address - Street 1:12022 BLUE VALLEY PKWY # 617
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2647
Practice Address - Country:US
Practice Address - Phone:833-957-0797
Practice Address - Fax:817-500-4677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty