SHANE MALONE REPT, CNIM
NPI 1508421108
Specialist/Technologist, Other - Electroneurodiagnostic in Tyler, TX

Q: What is the provider's specialty?

The provider's specialty is Specialist/Technologist, Other with taxonomy code 246ZE0600X and a focus in Electroneurodiagnostic.

Active since May 08, 2019

1356 OLD CREEK DR, TYLER, TX 75703(903) 534-0809(903) 939-9149 Get Directions Write a Review

NPPES record last updated: May 8, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Shane Malone Rept, Cnim NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANE MALONE REPT, CNIM (NPI 1508421108) is an individual electroneurodiagnostic provider in Tyler, Texas, licensed in Texas (2580) and active in the NPI registry since May 2019.

NPPES Registry Identity

NPI1508421108

Entity TypeIndividualMale

Primary Taxonomy246ZE0600X

Provider Legal NameSHANE MALONECredential: REPT, CNIM

Location Address1356 OLD CREEK DRTyler, TX 75703-7642

Mailing Address1356 Old Creek DrTyler, TX 75703-7642 · (903) 534-0809

Phone(903) 534-0809

Fax(903) 939-9149

Sole ProprietorYes

Enumeration DateMay 8, 2019

✔ NPI 1508421108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySpecialist/Technologist, Other · ElectroneurodiagnosticTechnologists, Technicians & Other Technical Service Providers

Taxonomy Code246ZE0600X

License✔ Licensed in TX · 2580

Also ListedSpecialist/Technologist, Other · EEGTaxonomy 246ZE0500X

Also ListedSpecialist/Technologist, Other · Surgical TechnologistTaxonomy 246ZS0410X

1356 OLD CREEK DR, Tyler, TX 75703

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Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRENT T ALFORD MD PA

Neurological Surgery