MEDICARE: ELECTROPHYSIOLOGY TESTING SERVICES PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2084N0400X	Neurology Physician
2	246ZE0600X	Electroneurodiagnostic Specialist/Technologist
3	204R00000X	Electrodiagnostic Medicine Physician
4	2084N0600X	Clinical Neurophysiology Physician

General Provider Information

NPI Number	:	1487413217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELECTROPHYSIOLOGY TESTING SERVICES PLLC

Provider Business Mailing Address
First Line	:	1141 N LOOP 1604 E # 105-612
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-1339
Country	:	US
Telephone Number	:	210-598-4277
Fax Number	:

Provider Business Practice Location Address
First Line	:	5339 SPRING VALLEY RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75254-3009
Country	:	US
Telephone Number	:	210-598-4277
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DUANE PITT
Credential	:	MD
Telephone Number	:	210-598-4277

Provider Enumeration Date	:	03/14/2024
Last Update Date	:	02/09/2026

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