Healthcare Provider Details

I. General information

NPI: 1144648676
Provider Name (Legal Business Name): TERRENCE SAUNDERS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 06/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 GRIEGOS RD NW
ALBUQUERQUE NM
87107-3752
US

IV. Provider business mailing address

1218 GRIEGOS RD NW
ALBUQUERQUE NM
87107-3752
US

V. Phone/Fax

Practice location:
  • Phone: 505-331-2970
  • Fax:
Mailing address:
  • Phone: 615-444-7759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471M2300X
TaxonomyMammography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: