Ian O'Fallon, CNIM

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

License

2897 Issued in NU

Practice address

33518 Haley Rd # 1
Waller, TX 77484-5110

Phone

(888) 344-2947

Fax

(281) 622-4381

NPI assigned

Feb 25, 2015

Last updated

Dec 5, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Atlas Neurophysiological Assessment

  dba Atlas Neurophysiological Assessment LLC

  • Electrodiagnostic Medicine Physician
  • Richardson, TX
  • NPI 1407142235
  NPD (past)
• Axis Neuromonitoring

  • Electroneurodiagnostic Specialist/Technologist
  • Richardson, TX
  • NPI 1093013310
  NPD (past)

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1891187076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1577",
            "city": "WALLER",
            "state": "TX",
            "postal_code": "774841577",
            "fax_number": "281-622-4381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33518 HALEY RD # 1",
            "city": "WALLER",
            "state": "TX",
            "postal_code": "774845110",
            "telephone_number": "888-344-2947",
            "fax_number": "281-622-4381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'FALLON",
        "first_name": "IAN",
        "credential": "CNIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-25",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": "NU",
            "license": "2897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Denise Miller, P.A.
• Mitchell TC LLC (Texas Care Waller)
• Motivate Bilingual Speech Therapy, LLC
• Calvin Nguyen, D.D.S.
• Priscilla Mmutaka Njoku, BPHARM
• Pamela A Odima, FNP
• Rachel Odwyer, CNIM
• Melanie Oslund-Goldberg, EPT
• Lindsay Shay Owen, OD
• Lorena Penaloza, M.S., CCC-SLP

• Electroneurodiagnostic Specialist/Technologist in Waller, TX
• Providers in Waller, TX by specialty
• Electroneurodiagnostic Specialist/Technologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.