Provider Demographics
NPI: | 1053972539 |
---|---|
Name: | HNP-IOM LLC |
Entity type: | Organization |
Organization Name: | HNP-IOM LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | SOLE MEMBER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LISAMARIE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PARTRIDGE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | CMC |
Authorized Official - Phone: | 972-412-5299 |
Mailing Address - Street 1: | 3526 LAKEVIEW PKWY STE B159 |
Mailing Address - Street 2: | |
Mailing Address - City: | ROWLETT |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75088-4176 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 972-412-5299 |
Mailing Address - Fax: | 469-453-3374 |
Practice Address - Street 1: | 5001 ROWLETT RD STE 300 |
Practice Address - Street 2: | |
Practice Address - City: | ROWLETT |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75088-4071 |
Practice Address - Country: | US |
Practice Address - Phone: | 972-412-5299 |
Practice Address - Fax: | 469-453-3374 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-06-25 |
Last Update Date: | 2019-12-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 246ZE0600X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Electroneurodiagnostic | Group - Single Specialty |