Eulessverse Iom, LLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

EULESSVERSE IOM, LLC

Practice address

803 Little Cub Way
Euless, TX 76039

Phone

(817) 809-6670

Fax

(817) 887-4887

NPI assigned

Sep 16, 2020

Organization subpart

No

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

Authorized official

Name

Nichole K Crites

Title

Manager

Phone

(817) 823-8001

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1922614940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 LITTLE CUB WAY",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "76039",
            "telephone_number": "817-809-6670",
            "fax_number": "817-887-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 LITTLE CUB WAY",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "76039",
            "telephone_number": "817-809-6670",
            "fax_number": "817-887-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EULESSVERSE IOM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "CRITES",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "817-823-8001"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurological Surgery Physician in Euless, TX
• Providers in Euless, TX by specialty
• Neurological Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.