Organization Active NPI

Olympia Neurological Institute PLLC

  • Neurological Surgery Physician
  • Georgetown, TX
National Provider Identifier
1699627661
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
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, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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)CodeLicenseStatePrimary
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 Directory

Locations

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.

Verify at the official NPI Registry.