MEDICARE: ROCKY MOUNTAIN MONITORING AND ASSIST, 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	2084N0600X	Clinical Neurophysiology Physician

General Provider Information

NPI Number	:	1710123179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKY MOUNTAIN MONITORING AND ASSIST, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1288
Second Line	:
City	:	CROSBY
State	:	TX
Zip	:	77532-1288
Country	:	US
Telephone Number	:	281-462-1285
Fax Number	:	281-462-1554

Provider Business Practice Location Address
First Line	:	8500 PARK MEADOWS DR STE 210
Second Line	:
City	:	LONE TREE
State	:	CO
Zip	:	80124-2744
Country	:	US
Telephone Number	:	281-462-1285
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT SHAY BESS
Credential	:	M.D.
Telephone Number	:	281-462-1285

Provider Enumeration Date	:	01/06/2009
Last Update Date	:	01/06/2009

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