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General NPI Number Information
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NPI Number | 1710406152
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Entity Type | Organization
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Legal Business Name | PEAK IOM , LLC
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Dates
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Enumeration Date | 09/18/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5318 WESLAYAN ST STE 195
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City | HOUSTON
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State | TX
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Zip | 77005-1048
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Country | US
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Telephone | 502-407-1434
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Fax |
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Provider Business Mailing Address
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Address Line | 5318 WESLAYAN ST STE 195
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City | HOUSTON
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State | TX
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Zip | 77005-1048
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Country | US
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Telephone | 502-407-1434
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | CHAD MILLER
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Credential |
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Telephone | 504-407-1434
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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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