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General NPI Number Information
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NPI Number | 1114312659
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Entity Type | Organization
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Legal Business Name | UNITED SHOCKWAVE SERVICES, LTD.
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Dates
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Enumeration Date | 04/01/2015
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 1990 STEAM WAY STE A102
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City | ROUND ROCK
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State | TX
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Zip | 78665-2233
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Country | US
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Telephone | 877-465-4845
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Fax | 847-544-5955
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Provider Business Mailing Address
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Address Line | PO BOX 95439
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City | GRAPEVINE
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State | TX
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Zip | 76099-9735
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Country | US
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Telephone | 877-465-4845
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Fax | 847-297-8853
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JEFFREY NORRIS
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Credential |
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Telephone | 847-544-5853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QL0400X
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Taxonomy Name | Lithotripsy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 3514
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License Number State | NM
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