Organization
JUAN CARLOS DE LA CERDA
Active
Other names
SONO DIAGNOSTICS OF WEST TEXAS
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN CARLOS DE LE CERDA RVT, RVS, RDCS, RCS (OWNER)
(806) 791-5930
Entity
Organization
Contact information
Practice address
1902 50TH ST, LUBBOCK, TX 79412-2706
(806) 771-1386
(806) 771-1388
Mailing address
PO BOX 54136, LUBBOCK, TX 79453-4136
(806) 771-1386
(806) 771-1388
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
25718
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00MDXO
BLUE CROSS BLUE SHIELD
TX
01
—
0147DC
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/15/2006
Last updated
08/04/2008
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