Active NPI
Olympia Neurological Institute PLLC
- Neurological Surgery Physician
- Georgetown, TX
National Provider Identifier
1699627661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- Legal business name
- OLYMPIA NEUROLOGICAL INSTITUTE PLLC
- Practice address
- 1502 Blue Ridge Dr Ste 301
Georgetown, TX 78626-1002 - Phone
- (512) 409-9903
- Fax
- (918) 493-3304
- NPI assigned
- Feb 12, 2026
- Last updated
- Feb 12, 2026
- 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
- Tyesha Mosquito
- Title
- Physician Relations Director
- Phone
- (918) 519-4090
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | NU | Primary |
Addresses
Primary practice location
1502 Blue Ridge Dr Ste 301
Georgetown, TX 78626-1002
Mailing address
6130 E 81St St
Tulsa, OK 74137-2125
Phone (918) 401-1002
Other practice location 1
4207 James Casey St Ste 111
Austin, TX 78745-3362
Phone (512) 409-9903
Other practice location 2
5615 Kyle Center Dr
Kyle, TX 78640-6553
Phone (512) 409-9903
National Provider Directory
National Provider DirectoryLocations
1502 Blue Ridge Dr
Ste 301
Georgetown, TX 78626
Phone (512) 409-9903
5615 Kyle Center Dr
Kyle, TX 78640
Phone (512) 409-9903
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1770854400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1770854400000",
"number": "1699627661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6130 E 81ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741372125",
"telephone_number": "918-401-1002",
"fax_number": "918-493-3304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1502 BLUE RIDGE DR STE 301",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786261002",
"telephone_number": "512-409-9903",
"fax_number": "918-493-3304"
}
],
"practiceLocations": [
{
"address_1": "4207 James Casey St Ste 111",
"address_purpose": "LOCATION",
"city": "Austin",
"state": "TX",
"postal_code": "787453362",
"country_code": "US",
"telephone_number": "512-409-9903",
"fax_number": "918-493-3304",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5615 Kyle Center Dr",
"address_purpose": "LOCATION",
"city": "Kyle",
"state": "TX",
"postal_code": "786406553",
"country_code": "US",
"telephone_number": "512-409-9903",
"fax_number": "918-493-3304",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "OLYMPIA NEUROLOGICAL INSTITUTE PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-02-12",
"last_updated": "2026-02-12",
"certification_date": "2026-02-12",
"status": "A",
"authorized_official_last_name": "MOSQUITO",
"authorized_official_first_name": "TYESHA",
"authorized_official_title_or_position": "PHYSICIAN RELATIONS DIRECTOR",
"authorized_official_telephone_number": "918-519-4090"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.