Healthcare Provider Details
I. General information
NPI: 1750573895
Provider Name (Legal Business Name): SANDRA HOUSTON RDMS,RVT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/13/2007
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
G3500 FLUSHING RD STE 104
FLINT MI
48504-4247
US
IV. Provider business mailing address
PO BOX 7087
FLINT MI
48507-0087
US
V. Phone/Fax
- Phone: 469-269-4986
- Fax:
- Phone: 469-269-4986
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0208X |
| Taxonomy | Mobile Radiology Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: