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NPI Code Detail

MEDICARE: GEMINI HEALTH LLC

MEDICARE: GEMINI HEALTH LLC
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
12084N0600XClinical Neurophysiology Physician
2246ZE0600XElectroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number : 1528598810
Entity Type Code : Organization
Provider Name (Legal Business Name) : GEMINI HEALTH LLC
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 :
Fax Number :
Provider Business Practice Location Address
First Line : 5080 SPECTRUM DR STE 1100E
Second Line :
City : ADDISON
State : TX
Zip : 75001-4688
Country : US
Telephone Number : 404-965-0089
Fax Number :
Authorized Official
Title or Position : CLIENT EXPERIENCE MANAGER
Name : ROXANNA LAROQUE
Credential :
Telephone Number : 210-598-2800
Provider Enumeration Date : 06/19/2017
Last Update Date : 05/09/2022

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Directions to “GEMINI HEALTH LLC ” Practice Location

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