Active NPI
1012 Diagnostics, PLLC
- Clinical Neurophysiology Physician
- Highland Village, TX
National Provider Identifier
1457076663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neurophysiology Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Electrodiagnostic Medicine Physician | 204R00000X | |||
| Neurology Physician | 2084N0400X | |||
| Clinical Neurophysiology Physician | 2084N0600X | Primary | ||
| Electroneurodiagnostic Specialist/Technologist | 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 DirectoryNPI 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.