Provider Demographics
NPI:1508307174
Name:CLEAR PIX ULTRASOUND
Entity Type:Organization
Organization Name:CLEAR PIX ULTRASOUND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LETICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-224-6109
Mailing Address - Street 1:2600 SOUTH SHORE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2943
Mailing Address - Country:US
Mailing Address - Phone:832-224-6109
Mailing Address - Fax:832-476-9553
Practice Address - Street 1:2600 S SHORE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2943
Practice Address - Country:US
Practice Address - Phone:832-224-6109
Practice Address - Fax:832-476-9553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service