Healthcare Provider Details

I. General information

NPI: 1336671338
Provider Name (Legal Business Name): CODY NATHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CODY LOUIS NATHAN MD

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6427 MELISSA ST
PITTSBURGH PA
15206-4704
US

IV. Provider business mailing address

PO BOX 4439
HOUSTON TX
77210-4439
US

V. Phone/Fax

Practice location:
  • Phone: 855-864-4322
  • Fax: 866-540-2867
Mailing address:
  • Phone: 713-792-2991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberW4691
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberW4691
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: