Sonographic Imaging Services

Primary specialty

Sonography Radiologic TechnologistTaxonomy code 2471S1302X

License

115278 Issued in TX

Legal business name

SONOGRAPHIC IMAGING SERVICES

Practice address

2718A N Main St
Liberty, TX 77575-3909

Phone

(936) 336-3616

NPI assigned

Aug 31, 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

Virginia R Drake, RVT, RT, LVNNPI 1225132574

Title

Owner

Phone

(936) 336-3616

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Virginia R Drake, RVT, RT, LVN

  • Sonography Radiologic Technologist
  • Liberty, TX
  • NPI 1225132574
  NPD (past) Authorized official
• Dale Wayne Brock, APN

  • Nurse Practitioner
  • Winnie, TX
  • NPI 1922055292
  NPD (past)
• Brandy Michelle Roberts, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Baytown, TX
  • NPI 1629355698
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477664803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 222",
            "city": "LIBERTY",
            "state": "TX",
            "postal_code": "775750222",
            "telephone_number": "936-336-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2718A N MAIN ST",
            "city": "LIBERTY",
            "state": "TX",
            "postal_code": "775753909",
            "telephone_number": "936-336-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONOGRAPHIC IMAGING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-336-3616",
        "authorized_official_credential": "RVT, RT, LVN"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "TX",
            "license": "115278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "PL0308",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veronica Renee Roth, FNP-BC
• Jordin Seidel
• Diane Slack
• Brandon Kyle Smith, PA-C
• Ruby Smith, LCDC
• Southeast Texas Medical Inc. (Liberty Medical Mart)
• Spectrum Sprouts Therapy LLC
• Jessica Marie Stanley, LCDC
• Shelly Margaret States, P.A
• Tarkington I.S.D.

• Sonography Radiologic Technologist in Liberty, TX
• Providers in Liberty, TX by specialty
• Sonography Radiologic Technologist in Texas

• 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.