Organization
UNIVERSAL LASER TECHNOLOGIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL WAYNE DUNLAP MLSO (CEO)
(281) 633-9167
Entity
Organization
Contact information
Practice address
2423 CANEY CREEK COURT, RICHMOND, TX 77469
(281) 633-9167
(281) 633-8972
Mailing address
2423 CANEY CREEK COURT, RICHMOND, TX 77469
(281) 633-9167
(281) 633-8972
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
Z01520
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HH1565
BLUE CROSS BLUE SHIELD
TX
01
—
Z01520
BUREAU OF RADIOLOGY #
TX
Enumeration date
10/03/2006
Last updated
08/22/2020
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