Healthcare Provider Details

I. General information

NPI: 1417841016
Provider Name (Legal Business Name): TOP ULTRASOUND IMAGE, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LA JOYA PASS
LEANDER TX
78641-5176
US

IV. Provider business mailing address

300 LA JOYA PASS
LEANDER TX
78641-5176
US

V. Phone/Fax

Practice location:
  • Phone: 818-271-0028
  • Fax:
Mailing address:
  • Phone: 818-271-0028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MISS ANGELICA VENTURENO
Title or Position: PRESIDENT
Credential: RDMS
Phone: 818-271-0028