Healthcare Provider Details

I. General information

NPI: 1104146844
Provider Name (Legal Business Name): HOUSTON NEURO ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2010
Last Update Date: 06/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 WELLS FARGO DR STE 112
HOUSTON TX
77090-4044
US

IV. Provider business mailing address

530 WELLS FARGO DR STE 112
HOUSTON TX
77090-4044
US

V. Phone/Fax

Practice location:
  • Phone: 281-440-3500
  • Fax: 281-440-3504
Mailing address:
  • Phone: 281-440-3500
  • Fax: 281-440-3504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVE PURDON
Title or Position: COO
Credential: CNIM, BA
Phone: 281-440-3500