Basic Information
| Provider Information | |||||||||
| NPI: | 1417484320 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SONOPRO DIAGNOSTICS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6 PALOMA BEND PL | ||||||||
| Address2: | |||||||||
| City: | THE WOODLANDS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773892157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7138187481 | ||||||||
| FaxNumber: | 3182557584 | ||||||||
| Practice Location | |||||||||
| Address1: | 6 PALOMA BEND PL | ||||||||
| Address2: | |||||||||
| City: | THE WOODLANDS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773892157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7138187481 | ||||||||
| FaxNumber: | 3182557584 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | PORTER | ||||||||
| AuthorizedOfficialFirstName: | CHAD | ||||||||
| AuthorizedOfficialMiddleName: | THOMAS | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 7138187481 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.