Organization · NPI-2

Axon Neurodiagnostics INC

Physiological Laboratory · San Antonio, TX

NPI number1619857703
StatusActive
Last updated in NPPESNov 21, 2025

Details

NPI
1619857703
Entity type
Organization (NPI-2)
Legal business name
Axon Neurodiagnostics INC
Organization subpart
No
Enumeration date
Sep 8, 2025
Certification date
Nov 21, 2025
Last updated
Nov 21, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
293D00000X Physiological Laboratory––Yes
246ZE0500X Specialist/Technologist, Other, EEG––
246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic––

Practice location

22588 Scenic Loop Rd
San Antonio, TX 78255-2253

Phone 651-492-2137

Mailing address

22588 Scenic Loop Rd
San Antonio, TX 78255-2253

Phone 651-492-2137

Authorized official

Alexander Carr
Owner/President
6514922137

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