MEDICARE: QUANTUM NEURODIAGNOSTIC PHYSICIANS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1255203907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUANTUM NEURODIAGNOSTIC PHYSICIANS, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 889
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80151-0889
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12828 WILLOW CENTRE DR STE D
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77066-3043
Country	:	US
Telephone Number	:	888-803-6480
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	ANDREA HEIMANN
Credential	:	B.S.R. EEG T
Telephone Number	:	720-490-2069

Provider Enumeration Date	:	09/22/2025
Last Update Date	:	09/22/2025

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