KIOM, LLC (NPI# 1558906222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558906222 |
| Entity Type | Organization |
| Organization Name | KIOM, LLC |
| Practice Address |
1075 Griffin St W # 104 Dallas TX 75215-1026 |
| Mailing Address |
11625 Custer Rd Ste 110-154 Frisco TX 75035-8783 |
| Practice Telephone | 9724125299 |
| Practice Fax Number | 4694533374 |
| Mailing Telephone | 9724125299 |
| Mailing Fax Number | 4694533374 |
| Enumeration Date | 2019-11-16 |
| Last Update Date | 2020-01-14 |
| Authorized Official Name | GARY WILLIAMS (SOLE MEMBER) |
| Authorized Official Telephone | 7853412460 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2472E0500X |
Technician, Other Specialization: EEG |
Technologists, Technicians & Other Technical Service Providers | ||
| Y | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
1075 GRIFFIN ST W # 104 |
| City | DALLAS |
| State | TX |
| Zip Code | 75215-1026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184245201 | Ursula Liliana Barrreto | Behavior Technician | 1999 Scott St, Suite 900, Dallas, TX 75215 | 2020-04-29 |
| 1811546278 | Nereca Carol Jones | Technician | 5011 Colonial Avenue, Dallas, TX 75215 | 2019-09-09 |
| 1356826838 | Sa Foundation for Humanity Inc | Dentist | 1100 S. Arkard Street, Suite 180, Dallas, TX 75215 | 2018-10-01 |
| 1043710049 | Lawanda Shed | Registered Nurse | 2622 Hatcher St, Dallas, TX 75215 | 2018-02-15 |
| 1598205973 | Royond Patrick-hendrix | Psychologist | 1409 S Lamar St Apt 307, Dallas, TX 75215 | 2017-03-03 |
| 1760830566 | Medchiro Injury Rehab LLC | Chiropractor | 1619 Martin Luther King Jr Blvd, Dallas, TX 75215 | 2016-06-02 |
| 1245580315 | Irfan Jadavji | Family Medicine | 2922-b Martin Luther King, Jr. Blvd, Dallas, TX 75215 | 2012-09-14 |
| 1982904165 | Malcolm X Pediatric Clinic | Clinic/Center | 4432 Malcolm X Blvd., Dallas, TX 75215 | 2010-10-22 |
| 1750693669 | Lyric Dion Day | Registered Nurse | 2922 Martin Luther King Jr Blvd #124, Dallas, TX 75215 | 2010-07-08 |
| 1477759272 | Shang's Garden, Inc | Assisted Living Facility | 2617 Birmingham, Dallas, TX 75215 | 2007-06-27 |
| Find all providers in zip 75215 | ||||
| Taxonomy Code | 246ZE0600X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Electroneurodiagnostic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124667746 | Applied Intraoperative Care Technology | Specialist/Technologist, Other | 25 Highland Park Vlg # 100-469, Dallas, TX 75205-2789 | 2019-12-30 |
| 1366975450 | Kaitlyn Friese | Specialist/Technologist, Other | 5339 Alpha Rd Ste 450, Dallas, TX 75240-7306 | 2017-04-06 |
| 1275985277 | Physicians Interest, Lp | Specialist/Technologist, Other | 6125 Luther Ln # 175, Dallas, TX 75225-6202 | 2016-07-01 |
| 1588039788 | Douglas Yang | Specialist/Technologist, Other | 4849 Greenville Ave Ste 1125, Dallas, TX 75206-4155 | 2015-12-14 |
| 1003200544 | Jamie Rebekah Pearson | Specialist/Technologist, Other | 6437 South Point Dr., Dallas, TX 75248 | 2015-03-23 |
| 1205228293 | Samira Naim | Specialist/Technologist, Other | 3100 Monticello Ave Ste 210, Dallas, TX 75205-3442 | 2015-02-27 |
| 1639578123 | Adam Martin | Specialist/Technologist, Other | 3001 Monticello, 210, Dallas, TX 75205 | 2014-08-20 |
| 1235541509 | Revolution Monitoring | Specialist/Technologist, Other | 6437 Southpoint Dr, Dallas, TX 75248-2109 | 2014-05-21 |
| 1376884023 | Joseph Sangillo | Specialist/Technologist, Other | 17717 Vail St, Apt 1316, Dallas, TX 75287-6400 | 2013-03-05 |
| 1851657308 | Pinnacle Diagnostics, Pllc | Specialist/Technologist, Other | 6119 Greenville Avenue, #358, Dallas, TX 75206 | 2012-04-10 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.