Organization Active NPI

Center for Minimally Invasive Neurosurgery PLLC

  • Neurological Surgery Physician
  • Conroe, TX
National Provider Identifier
1952000523
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
CENTER FOR MINIMALLY INVASIVE NEUROSURGERY PLLC
Practice address
1020 Riverwood CT Ste 305
Conroe, TX 77304-2974
Phone
(832) 447-7494
Fax
(832) 510-0563
NPI assigned
Mar 2, 2023
Last updated
Mar 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Authorized official

Name
Praveen Reddy, MDNPI 1720060775
Title
Principal
Phone
(612) 961-7507

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X NU Primary

Addresses

Primary practice location

1020 Riverwood CT Ste 305
Conroe, TX 77304-2974

Mailing address

1020 Riverwood CT Ste 305
Conroe, TX 77304-2974
Phone (832) 447-7494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230327001977 TX Part B Supplier - Clinic/Group Practice 8921472325 Receives reassigned benefits from 5 practitioners
Practice locations: Willis, TX; Spring, TX; Huntsville, TX; Corpus Christi, TX; Conroe, TX; Kingwood, TX
O20231128001211 TX DME Supplier - Physician - Neurosurgery 8921472325 Practice locations: Conroe, TX

National Provider Directory

National Provider Directory

Locations

7121 Spid Dr
Ste 106
Corpus Christi, TX 78412
Phone (361) 353-2020

Practitioners & affiliated clinicians

Practitioners 5

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": "1677715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1952000523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 RIVERWOOD CT STE 305",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042974",
            "telephone_number": "832-447-7494",
            "fax_number": "832-510-0563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 RIVERWOOD CT STE 305",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042974",
            "telephone_number": "832-447-7494",
            "fax_number": "832-510-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR MINIMALLY INVASIVE NEUROSURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-02",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "PRAVEEN",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "612-961-7507",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.