NPIMap

Organization Active NPI

Neurodiagnostics Tex Inc

  • Electrodiagnostic Medicine Physician
  • Tyler, TX
National Provider Identifier
1841691763
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electrodiagnostic Medicine PhysicianTaxonomy code 204R00000X
Legal business name
NEURODIAGNOSTICS TEX INC
Practice address
1356 Old Creek Dr
Tyler, TX 75703-7642
Phone
(903) 534-0809
Fax
(903) 939-9149
NPI assigned
Sep 10, 2014
Last updated
Sep 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Authorized official

Name
Catherine Boldery
Title
President/Ceo
Phone
(903) 534-0809

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Electrodiagnostic Medicine Physician 204R00000X NU Primary

Addresses

Primary practice location

1356 Old Creek Dr
Tyler, TX 75703-7642

Mailing address

PO Box 1455
Whitehouse, TX 75791-1455
Phone (903) 534-0809

National Provider Directory

National Provider Directory
Tax ID family
Neurodiagnostic Tex LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725408000000",
    "number": "1841691763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1455",
            "city": "WHITEHOUSE",
            "state": "TX",
            "postal_code": "757911455",
            "telephone_number": "903-534-0809",
            "fax_number": "903-939-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1356 OLD CREEK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757037642",
            "telephone_number": "903-534-0809",
            "fax_number": "903-939-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURODIAGNOSTICS TEX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-10",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A",
        "authorized_official_last_name": "BOLDERY",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "903-534-0809"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "",
            "desc": "Electrodiagnostic Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.