Healthcare Provider Details

I. General information

NPI: 1659160315
Provider Name (Legal Business Name): HOUSTON NEUROLOGY & DIAGNOSTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 SAN FELIPE ST STE 310
HOUSTON TX
77063-1613
US

IV. Provider business mailing address

7700 SAN FELIPE ST STE 310
HOUSTON TX
77063-1613
US

V. Phone/Fax

Practice location:
  • Phone: 713-589-6146
  • Fax: 713-589-5768
Mailing address:
  • Phone: 713-589-6146
  • Fax: 713-589-5768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0301X
TaxonomyBrain Injury Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY FLUITT
Title or Position: PARTNER
Credential: DO
Phone: 713-589-6146