Basic Information
| Provider Information | |||||||||
| NPI: | 1083272736 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOUSTON NEURO SHIELD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7887 E BELLEVIEW AVE STE 500 | ||||||||
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| City: | GREENWOOD VILLAGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801116077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7202873093 | ||||||||
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| Address1: | 7887 E BELLEVIEW AVE STE 500 | ||||||||
| Address2: | |||||||||
| City: | GREENWOOD VILLAGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801116077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7202873093 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2019 | ||||||||
| LastUpdateDate: | 08/24/2022 | ||||||||
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| AuthorizedOfficialLastName: | HILL | ||||||||
| AuthorizedOfficialFirstName: | CAROLINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7202873093 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246ZE0600X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Electroneurodiagnostic |
No ID Information.