Organization Active NPI

Neurodiagnostic Labs of San Antonio Inc

  • Neurology Physician
  • San Antonio, TX
National Provider Identifier
1497832463
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NEURODIAGNOSTIC LABS OF SAN ANTONIO INC
Practice address
8042 Wurzbach Rd
Ste 640
San Antonio, TX 78229-3810
Phone
(210) 692-3436
Fax
(210) 614-3316
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Wendy J McGrath
Title
Office Administrator
Phone
(210) 692-3436

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

8042 Wurzbach Rd
Ste 640
San Antonio, TX 78229-3810

Mailing address

8042 Wurzbach Rd
Ste 640
San Antonio, TX 78229-3810
Phone (210) 692-3436

Other identifiers 1

IdentifierTypeStateIssuer
084B392MedicaidTX

National Provider Directory

National Provider Directory

Locations

8042 Wurzbach Rd
Ste 640
San Antonio, TX 78229
Phone (210) 614-3959

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497832463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8042 WURZBACH RD",
            "address_2": "STE 640",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293810",
            "telephone_number": "210-692-3436",
            "fax_number": "210-614-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8042 WURZBACH RD",
            "address_2": "STE 640",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293810",
            "telephone_number": "210-692-3436",
            "fax_number": "210-614-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURODIAGNOSTIC LABS OF SAN ANTONIO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCGRATH",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "210-692-3436"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084B392",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.