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Organization

SONOGRAPHIC IMAGING SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VIRGINIA R DRAKE RVT, RT, LVN (OWNER)
(936) 336-3616
Entity
Organization

Contact information

Practice address
2718A N MAIN ST, LIBERTY, TX 77575-3909
(936) 336-3616
Mailing address
PO BOX 222, LIBERTY, TX 77575-0222
(936) 336-3616

Taxonomy

Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
115278
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PL0308
BCBS PROVIDER NUMBER
TX
Enumeration date
08/31/2006
Last updated
08/22/2020
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