Organization Active NPI

Platinum Neuro Diagnostics, LLC

  • Neurology Chiropractor
  • Houston, TX
National Provider Identifier
1104064674
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
6932 Issued in TX
Legal business name
PLATINUM NEURO DIAGNOSTICS, LLC
Practice address
5535 Memorial Dr
Suite F #414
Houston, TX 77007-8021
Phone
(409) 833-9505
Fax
(409) 833-9525
NPI assigned
Jan 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Craig A Thiry, DC
Title
Owner/Provider
Phone
(409) 833-9505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN0400X 6932 TX Primary

Addresses

Primary practice location

5535 Memorial Dr
Suite F #414
Houston, TX 77007-8021

Mailing address

5535 Memorial Dr
Suite F #414
Houston, TX 77007-8021
Phone (409) 833-9505

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGOtherTXBCBS

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232496000000",
    "number": "1104064674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 MEMORIAL DR",
            "address_2": "SUITE F #414",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770078021",
            "telephone_number": "409-833-9505",
            "fax_number": "409-833-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 MEMORIAL DR",
            "address_2": "SUITE F #414",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770078021",
            "telephone_number": "409-833-9505",
            "fax_number": "409-833-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM NEURO DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-21",
        "last_updated": "2009-01-21",
        "status": "A",
        "authorized_official_last_name": "THIRY",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "409-833-9505",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "TX",
            "license": "6932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "PENDING",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.