Prico Health LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

PRICO HEALTH LLC

Doing business as

ION Neuro-Diagnostics

Practice address

787 E FM 1187 Ste C
Crowley, TX 76036-4357

Phone

(817) 297-8446

Fax

(866) 693-2857

NPI assigned

Mar 8, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Jehan C Providenza, MBA

Title

Ceo

Phone

(817) 297-8446

Specialties & licenses 3

Addresses

Other names 1

• ION Neuro-Diagnostics Doing business as

Locations

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516060800000",
    "number": "1235404260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "787 E FM 1187 STE C",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760364357",
            "telephone_number": "817-297-8446",
            "fax_number": "866-693-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 E FM 1187 STE C",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760364357",
            "telephone_number": "817-297-8446",
            "fax_number": "866-693-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRICO HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-08",
        "last_updated": "2018-01-16",
        "status": "A",
        "authorized_official_last_name": "PROVIDENZA",
        "authorized_official_first_name": "JEHAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-297-8446",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ION Neuro-Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physiological Laboratory in Crowley, TX
• Providers in Crowley, 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 16, 2018; 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.