MEDICARE: ALLIED MONITORING INNOVATIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician
2	246ZE0600X	Electroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number	:	1053793901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIED MONITORING INNOVATIONS LLC

Provider Business Mailing Address
First Line	:	4849 GREENVILLE AVE
Second Line	:	SUITE 1125
City	:	DALLAS
State	:	TX
Zip	:	75206-4130
Country	:	US
Telephone Number	:	214-368-4666
Fax Number	:	214-368-4668

Provider Business Practice Location Address
First Line	:	4849 GREENVILLE AVE
Second Line	:	SUITE 1125
City	:	DALLAS
State	:	TX
Zip	:	75206-4130
Country	:	US
Telephone Number	:	214-368-4666
Fax Number	:	214-368-4668

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	MR. CARLOS PALACIOS
Credential	:
Telephone Number	:	214-368-4666

Provider Enumeration Date	:	06/26/2015
Last Update Date	:	10/12/2016

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