Healthcare Provider Details

I. General information

NPI: 1770964983
Provider Name (Legal Business Name): NERVE INTEGRITY MONITORING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2015
Last Update Date: 06/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 W MAIN ST
LA PORTE TX
77571-5001
US

IV. Provider business mailing address

321 W MAIN ST
LA PORTE TX
77571-5001
US

V. Phone/Fax

Practice location:
  • Phone: 832-667-8132
  • Fax:
Mailing address:
  • Phone: 832-667-8132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY E KRAUS
Title or Position: REGISTERED AGENT
Credential: M.D.
Phone: 832-667-8132