Universal Laser Technologies, LLC

Primary specialty

Other Specialist/TechnologistTaxonomy code 246Z00000X

License

Z01520 Issued in TX

Legal business name

UNIVERSAL LASER TECHNOLOGIES, LLC

Practice address

2423 Caney Creek Court
Richmond, TX 77469

Phone

(281) 633-9167

Fax

(281) 633-8972

NPI assigned

Oct 3, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Russell Wayne Dunlap, MLSO

Title

Ceo

Phone

(281) 633-9167

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235224619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 CANEY CREEK COURT",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "77469",
            "telephone_number": "281-633-9167",
            "fax_number": "281-633-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 CANEY CREEK COURT",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "77469",
            "telephone_number": "281-633-9167",
            "fax_number": "281-633-8972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL LASER TECHNOLOGIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUNLAP",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "281-633-9167",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MLSO"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "TX",
            "license": "Z01520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "HH1565",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUREAU OF RADIOLOGY #",
            "identifier": "Z01520",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.