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General NPI Number Information
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NPI Number | 1134519895
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Entity Type | Organization
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Legal Business Name | IBIS HEALTHCARE, INC.
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Dates
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Enumeration Date | 02/02/2015
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 2100 WEST LOOP S SUITE 900
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City | HOUSTON
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State | TX
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Zip | 77027-3515
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Country | US
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Telephone | 180-038-5368
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 WEST LOOP S SUITE 900
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City | HOUSTON
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State | TX
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Zip | 77027-3515
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CMO
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Name | DR. ALEX SARDINA
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Credential | M.D.
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Telephone | 18003853682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0207X
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Taxonomy Name | Mobile Mammography Clinic/Center
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License Number |
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License Number State |
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