OrganizationActive
Itachico, PLLC
NPI 1417617986 · Clinical Neurophysiology Physician · Round Rock, TX
Provider details
- NPI number
- 1417617986
- Entity type
- Organization
- Primary specialty
- Clinical Neurophysiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Roxanna Laroque, Director of Client Experience(210) 598-4277
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Technologists, Technicians & Other Technical Service Providers
- Electrodiagnostic Medicine Physician204R00000X
Allopathic & Osteopathic Physicians
- Neurology Physician2084N0400X
Allopathic & Osteopathic Physicians
Practice location
2214 Hamlet Circle
Round Rock, TX 78664
Phone: (210) 598-4277
Approximate (ZIP-level) locationGet directions
Mailing address
1141 N Loop 1604 E # 105-612
San Antonio, TX 78232-1339
Registry dates
- Enumerated
- 2021-12-27
- Last updated
- 2024-10-03
- Certified
- 2021-12-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.