Kiowa Neuro Monitoring PLLC

Primary specialty

Electrodiagnostic Medicine PhysicianTaxonomy code 204R00000X

Legal business name

KIOWA NEURO MONITORING PLLC

Practice address

111 Boland St
211
Ft Worth, TX 76107-1263

Phone

(214) 269-3875

Fax

(903) 328-6568

NPI assigned

Aug 16, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paul Schulman

Title

Manager

Phone

(214) 315-6432

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471305600000",
    "number": "1720533128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BOLAND ST",
            "address_2": "211",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761071263",
            "telephone_number": "214-269-3875",
            "fax_number": "903-328-6568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BOLAND ST",
            "address_2": "211",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761071263",
            "telephone_number": "214-269-3875",
            "fax_number": "903-328-6568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIOWA NEURO MONITORING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-16",
        "last_updated": "2016-08-16",
        "status": "A",
        "authorized_official_last_name": "SCHULMAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "214-315-6432"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; 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.