Provider Demographics
NPI:1881141166
Name:ULTIMATE DIAGNOSTICS CENTER LLC
Entity type:Organization
Organization Name:ULTIMATE DIAGNOSTICS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDER
Authorized Official - Middle Name:EMMANUEL
Authorized Official - Last Name:LEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-620-8383
Mailing Address - Street 1:6010 MCPHERSON RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6206
Mailing Address - Country:US
Mailing Address - Phone:956-620-8383
Mailing Address - Fax:956-435-0165
Practice Address - Street 1:6010 MCPHERSON RD
Practice Address - Street 2:SUITE 140
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6206
Practice Address - Country:US
Practice Address - Phone:956-620-8383
Practice Address - Fax:956-435-0165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-05
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier