Over the Horizon Iom LLC

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

Legal business name

OVER THE HORIZON IOM LLC

Practice address

5080 Spectrum Drive Suite 1100E
Addison, TX 75001

Phone

(216) 282-9887

NPI assigned

Jun 19, 2017

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

Manager, Client Experience

Phone

(210) 598-2801

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652054400000",
    "number": "1881124113",
    "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 DRIVE SUITE 1100E",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "75001",
            "telephone_number": "216-282-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVER THE HORIZON IOM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-19",
        "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": "MANAGER, 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": []
}

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• 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.