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NPI Code Detail

MEDICARE: NEURO ANALYSIS DIAGNOSTICS, LLC

MEDICARE: NEURO ANALYSIS 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
1261QS1200XSleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number : 1801227814
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEURO ANALYSIS DIAGNOSTICS, LLC
Provider Business Mailing Address
First Line : 20403 UNIVERSITY BLVD
Second Line : STE. 300
City : SUGAR LAND
State : TX
Zip : 77478-4976
Country : US
Telephone Number : 832-362-7875
Fax Number : 832-365-6065
Provider Business Practice Location Address
First Line : 2825 W TOWN CENTER CIR
Second Line :
City : KINGWOOD
State : TX
Zip : 77339-3734
Country : US
Telephone Number : 281-302-5983
Fax Number : 832-365-6065
Authorized Official
Title or Position : PRESIDENT
Name : TIMOTHY CARLTON ALDRIDGE
Credential : BS, RRT
Telephone Number : 832-362-7875
Provider Enumeration Date : 12/02/2013
Last Update Date : 12/02/2013

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