Provider Demographics
NPI:1144730730
Name:N20 IOM
Entity type:Organization
Organization Name:N20 IOM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM
Authorized Official - Phone:832-930-1000
Mailing Address - Street 1:10330 LAKE RD STE E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-1696
Mailing Address - Country:US
Mailing Address - Phone:832-930-1000
Mailing Address - Fax:832-941-1150
Practice Address - Street 1:10330 LAKE RD STE E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1696
Practice Address - Country:US
Practice Address - Phone:832-930-1000
Practice Address - Fax:832-941-1150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty