Provider Demographics
NPI:1003064569
Name:MCINTYRE, EDWARD EUGENE
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:EUGENE
Last Name:MCINTYRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1646 SPRING CYPRESS RD
Mailing Address - Street 2:110
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-3617
Mailing Address - Country:US
Mailing Address - Phone:832-368-0853
Mailing Address - Fax:
Practice Address - Street 1:1646 SPRING CYPRESS RD
Practice Address - Street 2:110
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-3617
Practice Address - Country:US
Practice Address - Phone:832-368-0853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography