Active NPI
Wellspine Monitoring, PLLC
- Clinical Neurophysiology Physician
- Dallas, TX
National Provider Identifier
1720344179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neurophysiology Physician
- Legal business name
- WELLSPINE MONITORING, PLLC
- Practice address
- 25 Highland Park Village Ste 100
Dallas, TX 75205-2726 - Phone
- (469) 283-0202
- NPI assigned
- Apr 10, 2012
- 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
- Roxanna Laroque
- Title
- Director of Client Experience
- Phone
- (210) 598-2801
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neurophysiology Physician | 2084N0600X | Primary | ||
| Electroneurodiagnostic Specialist/Technologist | 246ZE0600X |
Addresses
Primary practice location
25 Highland Park Village Ste 100
Dallas, TX 75205-2726
Mailing address
1141 N Loop 1604 E #105-612
San Antonio, TX 78232
Phone (469) 283-0202
National Provider Directory
National Provider DirectoryLocations
25 Highland Park Vlg
Ste 100
Dallas, TX 75205
Phone (469) 283-0202
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334016000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1654819200000",
"number": "1720344179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1141 N LOOP 1604 E #105-612",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78232",
"telephone_number": "469-283-0202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 HIGHLAND PARK VILLAGE STE 100",
"city": "DALLAS",
"state": "TX",
"postal_code": "752052726",
"telephone_number": "469-283-0202"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLSPINE MONITORING, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-04-10",
"last_updated": "2022-06-10",
"certification_date": "2022-06-10",
"status": "A",
"authorized_official_last_name": "LAROQUE",
"authorized_official_first_name": "ROXANNA",
"authorized_official_title_or_position": "DIRECTOR OF CLIENT EXPERIENCE",
"authorized_official_telephone_number": "210-598-2801"
},
"taxonomies": [
{
"code": "2084N0600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Clinical Neurophysiology",
"state": null,
"license": null,
"primary": true
},
{
"code": "246ZE0600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.