Organization Active NPI

Wellspine Monitoring, PLLC

  • Clinical Neurophysiology Physician
  • Dallas, TX
National Provider Identifier
1720344179
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
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

Updated by the provider on Jun 10, 2022

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)CodeLicenseStatePrimary
Clinical Neurophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0600X Primary
Electroneurodiagnostic Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

Locations

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.

Verify at the official NPI Registry.