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General NPI Number Information
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NPI Number | 1407258940
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Entity Type | Organization
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Legal Business Name | E&E DIAGNOSTIC MEDICAL IMAGING AND HEALTH SPA, LLC.
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 09/16/2014
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Provider Practice Location Address
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Address Line | 5208 HARRISBURG BLVD STE E
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City | HOUSTON
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State | TX
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Zip | 77011-4250
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Country | US
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Telephone | 713-923-9126
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Fax | 713-923-9129
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Provider Business Mailing Address
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Address Line | 5208 HARRISBURG BLVD STE E
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City | HOUSTON
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State | TX
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Zip | 77011-4250
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Country | US
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Telephone | 713-923-9126
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Fax | 713-923-9129
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MS. CRISTELLA ULLOA
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Credential |
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Telephone | 713-826-2618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | E7200
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License Number State | TX
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