MEDICARE: NEUROMUSCULAR DIAGNOSTICS 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
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1699537670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROMUSCULAR DIAGNOSTICS LLC

Provider Business Mailing Address
First Line	:	4705 SPICEWOOD SPRINGS RD STE 200-1
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-8402
Country	:	US
Telephone Number	:	512-920-0140
Fax Number	:	512-920-0142

Provider Business Practice Location Address
First Line	:	4705 SPICEWOOD SPRINGS RD STE 200-1
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-8402
Country	:	US
Telephone Number	:	512-920-0140
Fax Number	:	512-920-0142

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	EMIL HUSSAIN
Credential	:
Telephone Number	:	512-920-0140

Provider Enumeration Date	:	01/25/2024
Last Update Date	:	01/25/2024

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