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General NPI Number Information
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NPI Number | 1629862776
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Entity Type | Organization
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Legal Business Name | GONEURO IOM LLC
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Dates
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Enumeration Date | 04/05/2025
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Last Update Date | 04/05/2025
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Provider Practice Location Address
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Address Line | 730 NORTH LOOP STE B
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City | HOUSTON
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State | TX
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Zip | 77009-1043
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Country | US
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Telephone | 713-353-4425
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Fax |
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Provider Business Mailing Address
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Address Line | 9205 EAGLE DR STE 300-451
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City | MONT BELVIEU
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State | TX
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Zip | 77523-5618
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Country | US
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Telephone | 713-353-4425
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Fax |
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Authorized Official
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Title or Position | CNIM
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Name | GREG DOSTER
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Credential |
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Telephone | 713-353-4425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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