NPIMap

Organization Active NPI

Azleverse Neuromonitoring LLC

  • Specialist
  • Fort Worth, TX
National Provider Identifier
1295121440
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
AZLEVERSE NEUROMONITORING LLC
Practice address
500 Throckmorton Street Unit 3012
Fort Worth, TX 76102
Phone
(817) 908-5292
Fax
(817) 885-7339
NPI assigned
Apr 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Authorized official

Name
Dr. Augusto C Lastimosa, M.D.
Title
Managing Member
Phone
(817) 366-4777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

500 Throckmorton Street Unit 3012
Fort Worth, TX 76102

Mailing address

500 Throckmorton Street Unit 3012
Fort Worth, TX 76102
Phone (817) 908-5292

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1295121440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 THROCKMORTON STREET UNIT 3012",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76102",
            "telephone_number": "817-908-5292",
            "fax_number": "817-885-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 THROCKMORTON STREET UNIT 3012",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76102",
            "telephone_number": "817-908-5292",
            "fax_number": "817-885-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZLEVERSE NEUROMONITORING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-14",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "LASTIMOSA",
        "authorized_official_first_name": "AUGUSTO",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "817-366-4777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; 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.