TEXAS NEURO PHYSIOLOGICAL ASSOCIATES, P.A. - NPI NUMBER 1336399062

Summary

Provider Name: TEXAS NEURO PHYSIOLOGICAL ASSOCIATES, P.A.

NPI Number: 1336399062

Clasification: Psychiatry & Neurology (2084N0600X)

Specialization: Clinical Neurophysiology

Address:
76 STARBRUSH CIR
COVINGTON, LA
ZIP 70433

Phone Number: (985) 845-4595



Detailed Information

TEXAS NEURO PHYSIOLOGICAL ASSOCIATES, P.A. is a clinical neurophysiologist in Covington, LA. The provider is clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). The assigned NPI number for this provider is 1336399062 and is registered as an organization entity type and is a multi-specialty group.

The provider's business address is:

76 STARBRUSH CIR
COVINGTON, LA
ZIP 70433-208
Phone: (985) 845-4595
Fax: (985) 871-6839

The provider's authorized official is Dan William Joachim .
The authorized official title is Medical Director and has the following contact phone number (985) 845-4595.

The enumeration date for this NPI number is 9/30/2008 and was last updated on 9/30/2008.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 2084N0600X Psychiatry & Neurology Clinical Neurophysiology Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1336399062 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name TEXAS NEURO PHYSIOLOGICAL ASSOCIATES, P.A. The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 76 STARBRUSH CIR The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Business Practice Location Address City Name COVINGTON The city name in the location address of the provider being identified.
7 Provider Business Practice Location Address State Name LA The State code in the location of the provider being identified.
8 Provider Business Practice Location Address Postal Code 704337208 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
9 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
10 Provider Business Practice Location Address Telephone Number 9858454595 The telephone number associated with the location address of the provider being identified.
11 Provider Business Practice Location Address Fax Number 9858716839 The fax number associated with the location address of the provider being identified.
12 Provider Enumeration Date 9/30/2008 The date the provider was assigned a unique identifier (assigned an NPI).
13 Last Update Date 9/30/2008 The date that a record was last updated or changed.
14 Authorized Official Last Name JOACHIM The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
15 Authorized Official First Name DAN The first name of the authorized official.
16 Authorized Official Middle Name WILLIAM The middle name of the authorized official.
17 Authorized Official Title or Position MEDICAL DIRECTOR The title or position of the authorized official.
18 Authorized Official Telephone Number 9858454595 The 10-position telephone number of the authorized official.
19 Healthcare Provider Taxonomy Code 1 2084N0600X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Is Organization Subpart N
22 Authorized Official Name Prefix Text DR.
23 Authorized Official Credential Text M.D.
24 Healthcare Provider Taxonomy Group 1 193200000X MULTI-SPECIALTY GROUP

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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