Organization · NPI-2

1012 Diagnostics, PLLC

· Highland Village, TX

NPI number1457076663

StatusActive

Last updated in NPPESOct 10, 2022

Details

NPI: 1457076663
Entity type: Organization (NPI-2)
Legal business name: 1012 Diagnostics, PLLC
Organization subpart: No
Enumeration date: Oct 10, 2022
Certification date: Oct 10, 2022
Last updated: Oct 10, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
2084N0600X		–	–	Yes
204R00000X	Electrodiagnostic Medicine	–	–
2084N0400X	Psychiatry & Neurology, Neurology	–	–
246ZE0600X	Specialist/Technologist, Other, Electroneurodiagnostic	–	–

Practice location

3105 Overlook Cir
Highland Village, TX 75077-1840

Phone 210-598-4277

Mailing address

1141 N Loop 1604 E # 105-612
San Antonio, TX 78232-1339

Phone 210-598-4277

Authorized official

Roxanna Laroque
Director Of Client Experience
2105984277

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.