MEDICARE: MRS. SANTY THOMAS SONOGRAOHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2471S1302X	Sonography Radiologic Technologist
2	2085U0001X	Diagnostic Ultrasound Physician	144821	TX
3	2471V0105X	Vascular Sonography Radiologic Technologist
4	246XS1301X	Sonography Specialist/Technologist Cardiovascular

General Provider Information

NPI Number	:	1689181943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SANTY THOMAS SONOGRAOHER

Provider Business Mailing Address
First Line	:	3910 N JACKSON RD
Second Line	:
City	:	PHARR
State	:	TX
Zip	:	78577-7768
Country	:	US
Telephone Number	:	956-551-8840
Fax Number	:	718-740-2344

Provider Business Practice Location Address
First Line	:	3910 N JACKSON RD
Second Line	:
City	:	PHARR
State	:	TX
Zip	:	78577-7768
Country	:	US
Telephone Number	:	956-551-8840
Fax Number	:	718-740-2344

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2018
Last Update Date	:	01/08/2018

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