Rachel Odwyer, CNIM

Individual provider Active NPI Electroneurodiagnostic Specialist/Technologist · Waller, TX

NPI 1689936734 · NPPES record last updated Jun 14, 2012

Key facts

NPI
1689936734
Entity type
Individual (NPI type 1)
Primary specialty
Electroneurodiagnostic Specialist/Technologist 246ZE0600X
License
2274 (TX)
Practice address
33518 Haley Rd
# 1
Waller, TX 77484-5110
Phone
(888) 344-2947
Fax
(888) 344-2947
NPI assigned
Jun 14, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2274TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Axis Neuromonitoring Electroneurodiagnostic Past Accepting new patients
Atlas Neurophysiological Assessment Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/Technologist 246ZE0600X 2274 TX Yes

Addresses

Primary practice location

33518 Haley Rd
# 1
Waller, TX 77484-5110

Mailing address

PO Box 1577
Waller, TX 77484-1577

Other providers in Waller, TX

All providers in Waller, TX · Electroneurodiagnostic Specialist/Technologist in Texas

Sources for this page

Verify at the official NPI Registry.