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General NPI Number Information
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NPI Number | 1972684637
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Entity Type | Organization
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Legal Business Name | SKELETAL DIAGNOSTICS OF SEALY
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 02/02/2012
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Provider Practice Location Address
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Address Line | 526 WARD ST SUITE 135
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City | SEALY
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State | TX
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Zip | 77474-2651
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Country | US
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Telephone | 281-352-4983
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 945
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City | BELLVILLE
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State | TX
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Zip | 77418-0945
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Country | US
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Telephone | 979-865-3124
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Fax |
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Authorized Official
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Title or Position | MANAGER/TECHNICIAN
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Name | DIANE ABEL
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Credential |
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Telephone | 281-352-4983
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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 |
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License Number State |
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