Neurovative Diagnostics LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

NEUROVATIVE DIAGNOSTICS LLC

Practice address

16800 Dallas Pkwy Ste 175
Dallas, TX 75248-1941

Phone

(972) 361-8040

NPI assigned

Mar 29, 2016

Organization subpart

No

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

Authorized official

Name

Anthony Darrel Wax

Title

Ceo

Phone

(214) 802-1078

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jay Harrison Harvey, DO

  • Epilepsy Physician
  • Dallas, TX
  • NPI 1972511517
  NPD
• Neil Ghanshyam Patel, MD

  • Neurology Physician
  • Mt Pleasant, SC
  • NPI 1477992063
  NPD (past)

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1114380102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16800 DALLAS PKWY STE 175",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481941",
            "telephone_number": "972-361-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16800 DALLAS PKWY STE 175",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481941",
            "telephone_number": "972-361-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROVATIVE DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-29",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "WAX",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "DARREL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-802-1078"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neurosynaptics, LLC
• Neurotechnology, LLC
• Neurotex Diagnostics, PLLC
• Neurotherapeutic
• Neurotherapy Center of Dallas
• Neuroview PLLC
• Neurowellness
• Simone Amanda Neuwelt, MD
• Nevaeh Home Health Care
• Nicole Michelle Nevarez, M.D.

• Physiological Laboratory in Dallas, TX
• Providers in Dallas, TX by specialty
• Physiological Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.