Organization
MODERN NEUROMONITORING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZETTE MORIN (MDMS NPI COMPLIANCE OFFICER)
(210) 598-2800
Entity
Organization
Contact information
Practice address
1302 WAUGH DR # 695, HOUSTON, TX 77019-3908
(281) 204-2217
Mailing address
1302 WAUGH DR # 695, HOUSTON, TX 77019-3908
(281) 204-2217
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
04/07/2016
Last updated
07/10/2018
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