Organization Active NPI

Modern Neuromonitoring, PLLC

  • Clinical Neurophysiology Physician
  • Houston, TX
National Provider Identifier
1942664792
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
Legal business name
MODERN NEUROMONITORING, PLLC
Practice address
1302 Waugh Dr # 695
Houston, TX 77019-3908
Phone
(281) 204-2217
NPI assigned
Apr 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Authorized official

Name
Lizette Morin
Title
MDMS Npi Compliance Officer
Phone
(210) 598-2800

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Electrodiagnostic Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 204R00000X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Clinical Neurophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0600X Primary
Electroneurodiagnostic Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 246ZE0600X

Addresses

Primary practice location

1302 Waugh Dr # 695
Houston, TX 77019-3908

Mailing address

1302 Waugh Dr # 695
Houston, TX 77019-3908
Phone (281) 204-2217

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531180800000",
    "number": "1942664792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 WAUGH DR # 695",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770193908",
            "telephone_number": "281-204-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 WAUGH DR # 695",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770193908",
            "telephone_number": "281-204-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN NEUROMONITORING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-07",
        "last_updated": "2018-07-10",
        "status": "A",
        "authorized_official_last_name": "MORIN",
        "authorized_official_first_name": "LIZETTE",
        "authorized_official_title_or_position": "MDMS NPI COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "210-598-2800"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.