Organization Active NPI

1012 Diagnostics, PLLC

  • Clinical Neurophysiology Physician
  • Highland Village, TX
National Provider Identifier
1457076663
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
Legal business name
1012 DIAGNOSTICS, PLLC
Practice address
3105 Overlook Cir
Highland Village, TX 75077-1840
Phone
(210) 598-4277
NPI assigned
Oct 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Authorized official

Name
Mrs. Roxanna Laroque
Title
Director of Client Experience
Phone
(210) 598-4277

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Electrodiagnostic Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 204R00000X
Neurology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084N0400X
Clinical Neurophysiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084N0600X Primary
Electroneurodiagnostic Specialist/TechnologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 246ZE0600X

Addresses

Primary practice location

3105 Overlook Cir
Highland Village, TX 75077-1840

Mailing address

1141 N Loop 1604 E # 105-612
San Antonio, TX 78232-1339
Phone (210) 598-4277

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1457076663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 N LOOP 1604 E # 105-612",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321339",
            "telephone_number": "210-598-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 OVERLOOK CIR",
            "city": "HIGHLAND VILLAGE",
            "state": "TX",
            "postal_code": "750771840",
            "telephone_number": "210-598-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1012 DIAGNOSTICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A",
        "authorized_official_last_name": "LAROQUE",
        "authorized_official_first_name": "ROXANNA",
        "authorized_official_title_or_position": "DIRECTOR OF CLIENT EXPERIENCE",
        "authorized_official_telephone_number": "210-598-4277",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Village, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.