Healthcare Provider Details

I. General information

NPI: 1316560436
Provider Name (Legal Business Name): OMEGA NEUROMONITORING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2020
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 PARK ROWE AVE
BATON ROUGE LA
70810-1686
US

IV. Provider business mailing address

3526 LAKEVIEW PKWY # B159
ROWLETT TX
75088-4176
US

V. Phone/Fax

Practice location:
  • Phone: 225-315-2428
  • Fax:
Mailing address:
  • Phone: 844-868-1971
  • Fax: 469-453-3374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KYLE LAMBETH
Title or Position: CEO
Credential:
Phone: 225-315-2428