Provider Demographics
NPI:1235469701
Name:ULTRASONIDO MI BEBE
Entity Type:Organization
Organization Name:ULTRASONIDO MI BEBE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:
Authorized Official - Last Name:WETTSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-687-8525
Mailing Address - Street 1:150 W PARKER RD STE 603
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-2939
Mailing Address - Country:US
Mailing Address - Phone:832-687-8525
Mailing Address - Fax:
Practice Address - Street 1:150 W PARKER RD STE 603
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-2939
Practice Address - Country:US
Practice Address - Phone:832-687-8525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ULTRASONIDO MI BEBE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-06
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology