Provider Demographics
NPI:1497931547
Name:SONORUS MEDICAL IMAGING, LLC
Entity Type:Organization
Organization Name:SONORUS MEDICAL IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:BBA, RDMS, RVT
Authorized Official - Phone:940-389-0647
Mailing Address - Street 1:4285 OLD DECATUR RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALVORD
Mailing Address - State:TX
Mailing Address - Zip Code:76225-7748
Mailing Address - Country:US
Mailing Address - Phone:940-389-0647
Mailing Address - Fax:
Practice Address - Street 1:4285 OLD DECATUR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ALVORD
Practice Address - State:TX
Practice Address - Zip Code:76225-7748
Practice Address - Country:US
Practice Address - Phone:940-389-0647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX800921018261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center