Azle Neuromonitoring LLC

Organization Active NPI Neurological Surgery Physician · Azle, TX

NPI 1407265259 · NPPES record last updated Aug 6, 2014

Key facts

NPI
1407265259
Entity type
Organization (NPI type 2)
Primary specialty
Neurological Surgery Physician 207T00000X
License
N8651 (TX)
Legal business name
AZLE NEUROMONITORING LLC
Practice address
1244 Boling Ranch Road N
Azle, TX 76020
Phone
(817) 908-8124
Fax
(817) 885-7339
NPI assigned
Aug 6, 2014
Organization subpart
No

Authorized official

Name
Dr. Augusto Cezar Lastimosa, M.D.
Title
Managing Member
Phone
(817) 908-8124

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207T00000X N8651 TX Yes

Addresses

Primary practice location

1244 Boling Ranch Road N
Azle, TX 76020

Mailing address

1244 Boling Ranch Road N
Azle, TX 76020
Phone (817) 908-8124

Other providers in Azle, TX

All providers in Azle, TX · Neurological Surgery Physician in Texas

Sources for this page

Verify at the official NPI Registry.