Healthcare Provider Details
I. General information
NPI: 1891968988
Provider Name (Legal Business Name): INSIGHT NEUROMONITORING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/09/2008
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2411 FOUNTAIN VIEW DR STE 101
HOUSTON TX
77057-4851
US
IV. Provider business mailing address
2411 FOUNTAIN VIEW DR STE 101
HOUSTON TX
77057-4851
US
V. Phone/Fax
- Phone: 281-768-6742
- Fax:
- Phone: 281-768-6742
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 246ZE0600X |
| Taxonomy | Electroneurodiagnostic Specialist/Technologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
GEORGE
EDWARD
BRETZ
Title or Position: GENERAL PARTNER
Credential:
Phone: 281-768-6730