Healthcare Provider Details
I. General information
NPI: 1679935274
Provider Name (Legal Business Name): SCJ MONITORING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/23/2016
Last Update Date: 11/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6711 STELLA LINK RD # 384
WEST UNIVERSITY PLACE TX
77005-4342
US
IV. Provider business mailing address
6711 STELLA LINK RD # 384
WEST UNIVERSITY PLACE TX
77005-4342
US
V. Phone/Fax
- Phone: 713-955-8258
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 204R00000X |
| Taxonomy | Electrodiagnostic Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0600X |
| Taxonomy | Clinical Neurophysiology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 246ZE0600X |
| Taxonomy | Electroneurodiagnostic Specialist/Technologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STANLEY
C
JONES
Title or Position: PRESIDENT
Credential: M.D.
Phone: 713-955-8258