Provider Demographics
NPI:1326661190
Name:PRECISE VASCULAR SONOGRAPHY LLC
Entity Type:Organization
Organization Name:PRECISE VASCULAR SONOGRAPHY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICAH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RVT
Authorized Official - Phone:210-251-2024
Mailing Address - Street 1:24618 WINE ROSE PATH
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-2266
Mailing Address - Country:US
Mailing Address - Phone:210-251-2024
Mailing Address - Fax:210-742-9697
Practice Address - Street 1:718 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4768
Practice Address - Country:US
Practice Address - Phone:210-251-2024
Practice Address - Fax:210-742-9697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-27
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier