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Organization
WOODLANDS IONM LLC
Active
Organization
WOODLANDS IONM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AGITH MUTHALALY (OWNER)
(616) 843-7007
Entity
Organization
Contact information
Practice address
3786 FM 1488 RD STE 170, THE WOODLANDS, TX 77384-4988
(281) 721-9667
(281) 781-2540
Mailing address
10857 KUYKENDAHL RD STE 120, THE WOODLANDS, TX 77382-2937
Taxonomy
Speciality
Code
Description
License number
State
246ZE0500X
EEG Specialist/Technologist
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
11/29/2022
Last updated
05/08/2024
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