Red Granite Neuromonitoring LLC

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

Legal business name

RED GRANITE NEUROMONITORING LLC

Practice address

5080 Spectrum Dr Ste 1100E
Addison, TX 75001-4688

Phone

(262) 289-4322

NPI assigned

Oct 10, 2018

Organization subpart

No

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

Authorized official

Name

Roxanna Laroque

Title

Client Experience Manager

Phone

(210) 598-2800

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652054400000",
    "number": "1740755305",
    "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": "782321339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DR STE 1100E",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014688",
            "telephone_number": "262-289-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED GRANITE NEUROMONITORING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-10",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "LAROQUE",
        "authorized_official_first_name": "ROXANNA",
        "authorized_official_title_or_position": "CLIENT EXPERIENCE MANAGER",
        "authorized_official_telephone_number": "210-598-2800"
    },
    "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": []
}

• Raven Counseling Services, PLLC
• Ray Wellness, PLLC
• Courtney Ray, DC
• Elena Rebholz, DPT
• Stephanie Recendiz
• Red Maple Holdings, Inc
• Red River Neurodiagnostics, LLC
• Prathyusha Kethi Reddy, M.D.
• Rathidevi Reddy, M.D.
• Tyler Tymel Reed, PTA

• Clinical Neurophysiology Physician in Addison, TX
• Providers in Addison, TX by specialty
• Clinical Neurophysiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.