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General NPI Number Information
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NPI Number | 1548173347
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Entity Type | Organization
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Legal Business Name | ULTIMATE DIAGNOSTICS
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 7613 KING ARTHURS CT APT 32
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City | LAREDO
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State | TX
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Zip | 78041-2973
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Country | US
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Telephone | 956-469-0355
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Fax |
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Provider Business Mailing Address
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Address Line | 7613 KING ARTHURS CT APT 32
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City | LAREDO
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State | TX
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Zip | 78041-2973
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Country | US
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Telephone | 956-469-0355
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. MARTIN JESUS GONZALEZ JR.
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Credential |
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Telephone | 956-393-7531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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