Provider Demographics
NPI:1558684456
Name:PEEK A BABY WOODLANDS PRENATAL ULTRASOUND CENTER
Entity Type:Organization
Organization Name:PEEK A BABY WOODLANDS PRENATAL ULTRASOUND CENTER
Other - Org Name:PEEK A BABY WOODLANDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:WETTSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-237-7335
Mailing Address - Street 1:19075 I-45 S
Mailing Address - Street 2:STE 290
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77385-8701
Mailing Address - Country:US
Mailing Address - Phone:936-273-1800
Mailing Address - Fax:936-273-1823
Practice Address - Street 1:19075 I-45 S
Practice Address - Street 2:STE 290
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77385-8701
Practice Address - Country:US
Practice Address - Phone:936-273-1800
Practice Address - Fax:936-273-1823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-05
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty