Neurodiagnostic Tex, LLC

Primary specialty

Electrodiagnostic Medicine PhysicianTaxonomy code 204R00000X

Legal business name

NEURODIAGNOSTIC TEX, LLC

Practice address

1356 Old Creek Dr
Tyler, TX 75703-7642

Phone

(903) 534-0809

Fax

(903) 939-9149

NPI assigned

May 19, 2006

Last updated

Sep 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Catherine Boldery

Title

President/Ceo

Phone

(903) 534-0809

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Tax ID family

Neurodiagnostic Tex LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Neurodiagnostics Tex Inc

  • Electrodiagnostic Medicine Physician
  • Tyler, TX
  • NPI 1841691763
  NPD tax ID
• Neurodiagnostics Tex, LLC

  • Electrodiagnostic Medicine Physician
  • Texarkana, AR
  • NPI 1992283485
  NPD tax ID

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sarah Evans, CNIM

  • Surgical Technologist
  • Tyler, TX
  • NPI 1104192731
  NPD
• George William Kariampuzha, MD

  • Neurology Physician
  • Tyler, TX
  • NPI 1235103201
  NPD
• Thomas J Trese, DO

  • Neurology Physician
  • Tyler, TX
  • NPI 1306886353
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725408000000",
    "number": "1558314567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1455",
            "city": "WHITEHOUSE",
            "state": "TX",
            "postal_code": "757911455",
            "telephone_number": "903-534-0809",
            "fax_number": "903-939-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1356 OLD CREEK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757037642",
            "telephone_number": "903-534-0809",
            "fax_number": "903-939-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURODIAGNOSTIC TEX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A",
        "authorized_official_last_name": "BOLDERY",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "903-534-0809"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nethc, LLC (Right at Home of Northeast Texas)
• Nethclv, Inc (NorthStar Navigators)
• Tamara Neuenschwander, PMHNP
• Neuro Diagnostics LLC
• Neuro Ir of East Texas
• Neurodiagnostics Tex Inc
• Neurology Associates of Tyler, P.a.
• Neurotex Equipment & Supply
• New Columbian Optical Company (Payless Optical)
• New Concept Health Services, Inc

• Electrodiagnostic Medicine Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Electrodiagnostic Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.