Healthcare Provider Details

I. General information

NPI: 1982904405
Provider Name (Legal Business Name): ULTIMATE ULTRASOUND SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2010
Last Update Date: 11/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 MCCUE RD 321
HOUSTON TX
77056-4633
US

IV. Provider business mailing address

2300 MCCUE RD 321
HOUSTON TX
77056-4633
US

V. Phone/Fax

Practice location:
  • Phone: 806-787-7179
  • Fax:
Mailing address:
  • Phone: 806-787-7179
  • Fax: 281-664-5899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471V0106X
TaxonomyVascular-Interventional Technology Radiologic Technologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. DANNY CANTU
Title or Position: PRESIDENT
Credential:
Phone: 806-787-7179