Healthcare Provider Details

I. General information

NPI: 1316461304
Provider Name (Legal Business Name): CNS NEUEOSPINEMONITORING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 E. LOFTWOOD CIR
THE WOODLANDS TX
77382
US

IV. Provider business mailing address

4747 RESEARCH FOREST DR STE 180223
THE WOODLANDS TX
77381-4912
US

V. Phone/Fax

Practice location:
  • Phone: 713-936-3021
  • Fax: 281-419-1857
Mailing address:
  • Phone: 713-936-3021
  • Fax: 281-419-1857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: PERLITA MARI VARGAS
Title or Position: ORGANIZER
Credential:
Phone: 832-367-0759