Provider Demographics
NPI:1093142390
Name:DE VARONA SARDINAS, JOEL
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:
Last Name:DE VARONA SARDINAS
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 1:3030 ELMSIDE DR
Mailing Address - Street 2:APT 134
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-3968
Mailing Address - Country:US
Mailing Address - Phone:713-287-0922
Mailing Address - Fax:
Practice Address - Street 1:3030 ELMSIDE DR
Practice Address - Street 2:APT 134
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-3968
Practice Address - Country:US
Practice Address - Phone:713-287-0922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1496042471S1302X, 2471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography