1811151517 NPI number — MEDICAL SONOGRAPHY SERVICES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811151517 NPI number — MEDICAL SONOGRAPHY SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICAL SONOGRAPHY SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811151517
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
316 WILLOW SPRINGS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COPPELL
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75019-3357
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-483-5147
Provider Business Mailing Address Fax Number:
214-432-0627

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1612-2 SOUTH BRODAWAY STREET
Provider Second Line Business Practice Location Address:
SUITE#200
Provider Business Practice Location Address City Name:
CARROLLTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75006-8915
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-483-5147
Provider Business Practice Location Address Fax Number:
214-432-0627
Provider Enumeration Date:
07/11/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RINCON
Authorized Official First Name:
VICTOR
Authorized Official Middle Name:
PATRICK
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
214-483-5147

Provider Taxonomy Codes

  • Taxonomy code: 2085U0001X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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