Healthcare Provider Details

I. General information

NPI: 1619355724
Provider Name (Legal Business Name): LRMC NEUROSURGERY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2015
Last Update Date: 05/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEDICAL PKWY SUITE 310
LAKEWAY TX
78738-1791
US

IV. Provider business mailing address

100 MEDICAL PKWY
LAKEWAY TX
78738-5621
US

V. Phone/Fax

Practice location:
  • Phone: 512-654-2101
  • Fax:
Mailing address:
  • Phone: 512-571-5140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. PHILIPPE BOCHATON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 512-571-5140