Provider Demographics
NPI:1356734974
Name:SOUTHWEST ULTRASOUND SERVICES LLC
Entity type:Organization
Organization Name:SOUTHWEST ULTRASOUND SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VALENZUELA
Authorized Official - Suffix:
Authorized Official - Credentials:RTV, RVS, RCS
Authorized Official - Phone:575-640-7393
Mailing Address - Street 1:PO BOX 1643
Mailing Address - Street 2:
Mailing Address - City:FAIRACRES
Mailing Address - State:NM
Mailing Address - Zip Code:88033-1643
Mailing Address - Country:US
Mailing Address - Phone:575-522-5511
Mailing Address - Fax:575-532-1778
Practice Address - Street 1:141 N ROADRUNNER PKWY STE 137
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-2001
Practice Address - Country:US
Practice Address - Phone:575-522-5511
Practice Address - Fax:575-522-0825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty
No293D00000XLaboratoriesPhysiological Laboratory
No305S00000XManaged Care OrganizationsPoint of Service