MEDICARE: HOUSTON NEURODIAGNOSTICS, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261Q00000X	Clinic/Center
2	261QS1200X	Sleep Disorder Diagnostic Clinic/Center
3	293D00000X	Physiological Laboratory

General Provider Information

NPI Number	:	1558770727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON NEURODIAGNOSTICS, LLC

Provider Business Mailing Address
First Line	:	4545 FULLER DR STE 100
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-6509
Country	:	US
Telephone Number	:	469-995-8416
Fax Number	:	866-279-4704

Provider Business Practice Location Address
First Line	:	4545 FULLER DR STE 200
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-6522
Country	:	US
Telephone Number	:	281-936-0996
Fax Number	:	866-279-4704

Authorized Official
Title or Position	:	CEO
Name	:	CHARLES ALVAREZ
Credential	:
Telephone Number	:	469-995-8416

Provider Enumeration Date	:	08/12/2014
Last Update Date	:	01/28/2026

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