MONTLAKE DIAGNOSTICS, PLLC
NPI 1760841258
Psychiatry & Neurology - Clinical Neurophysiology in San Antonio, TX

NPI Status: Active since February 12, 2016

Contact Information

1819 N MAIN AVE # 218
SAN ANTONIO, TX
ZIP 78212
Phone: (210) 714-5532

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  • Organization
  • Psychiatry & Neurology
  • Clinical Neurophysiology

About MONTLAKE DIAGNOSTICS, PLLC

This page provides the complete NPI Profile along with additional information for Montlake Diagnostics, Pllc, a provider established in San Antonio, Texas operating as a Psychiatry & Neurology, focusing in clinical neurophysiology . The healthcare provider is registered in the NPI registry with number 1760841258 assigned on February 2016. The practitioner's primary taxonomy code is 2084N0600X. The provider is registered as an organization and their NPI record was last updated 9 years ago. Montlake Diagnostics, Pllc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Dr. William Alec Tisdall M.d. (Owner)

NPI
1760841258
Provider Name
MONTLAKE DIAGNOSTICS, PLLC
Entity Type
Organization
Location Address
1819 N MAIN AVE # 218 SAN ANTONIO, TX 78212
Location Phone
(210) 714-5532
Mailing Address
1819 N MAIN AVE # 218 SAN ANTONIO, TX 78212
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-12-2016
Last Update Date
11-16-2016
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychiatry & Neurology Clinical Neurophysiology

Taxonomy Code
2084N0600X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
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).

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1204R00000XAllopathic & Osteopathic Physicians

Electrodiagnostic Medicine

 
22084N0400XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Neurology

 
3246ZE0600XTechnologists, Technicians & Other Technical Service Providers

Specialist/Technologist, Other
Electroneurodiagnostic

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. WILLIAM ALEC TISDALL M.D.

Authorized Official Title
OWNER
Authorized Official Phone
(210) 714-5532

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1760841258
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
271201642210
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 2 + 0 + 1 + 6 + 4 + 2 + 2 + 1 + 0 + 24 = 52
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 52 = 88

The NPI number 1760841258 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1760841258, enumerated as an "organization" on February 12, 2016.

The provider is located at 1819 N MAIN AVE # 218 SAN ANTONIO, TX 78212 and the phone number is (210) 714-5532.

Psychiatry & Neurology with taxonomy code 2084N0600X and a focus in Clinical Neurophysiology.