Waveform Neuromonitoring, LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

WAVEFORM NEUROMONITORING, LLC

Practice address

503 Medical Center Blvd Ste 110
Conroe, TX 77304-2928

Phone

(936) 756-3459

Fax

(936) 756-3452

NPI assigned

Feb 13, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Anisa Gopalani, MD

Title

Physician Partner

Phone

(832) 236-5922

Specialties & licenses 1

Addresses

Other names 1

• Waveform Neuromonitoring, LLC Former legal business name

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550016000000",
    "number": "1215493366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 N LOOP 336 W STE B",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043637",
            "telephone_number": "936-756-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 MEDICAL CENTER BLVD STE 110",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042928",
            "telephone_number": "936-756-3459",
            "fax_number": "936-756-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVEFORM NEUROMONITORING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-13",
        "last_updated": "2019-02-13",
        "status": "A",
        "authorized_official_last_name": "GOPALANI",
        "authorized_official_first_name": "ANISA",
        "authorized_official_title_or_position": "PHYSICIAN PARTNER",
        "authorized_official_telephone_number": "832-236-5922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waveform Neuromonitoring, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Carissa Dawn Watson-Ramos, LCSW
• Alyssa Watson, LPC
• Jennifer Lynne Watson
• Kathleen Ann Watson, MD
• Brittani Kiara Watts
• Dave Waxler, LPC
• Dale Weathersby, D.C.
• Jason Henry Weber, CSFA
• Edmund Byron Webster IV, PA-C
• Sharhonda Webster, LPC

• Neurology Physician in Conroe, TX
• Providers in Conroe, TX by specialty
• Neurology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; 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.