Healthcare Provider Details

I. General information

NPI: 1316379423
Provider Name (Legal Business Name): DMOUMO NEUROMONITOR PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2013
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13161 MISTY WILLOW DR
HOUSTON TX
77070-5635
US

IV. Provider business mailing address

18100 SAINT JOHN DR SUITE 230
HOUSTON TX
77058-3631
US

V. Phone/Fax

Practice location:
  • Phone: 281-970-5900
  • Fax: 281-970-5913
Mailing address:
  • Phone: 281-970-5900
  • Fax: 281-970-5913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name: MR. RAY ERIC SANTOS
Title or Position: MANAGER
Credential: M.D.
Phone: 281-970-5900