Provider Demographics
NPI:1104571769
Name:SAUCEDA, EUNICE T (RDMS, RT (R))
Entity type:Individual
Prefix:
First Name:EUNICE
Middle Name:T
Last Name:SAUCEDA
Suffix:
Gender:F
Credentials:RDMS, RT (R)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3314 E DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-1458
Mailing Address - Country:US
Mailing Address - Phone:956-207-6351
Mailing Address - Fax:
Practice Address - Street 1:3314 E DAVIS RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542-1458
Practice Address - Country:US
Practice Address - Phone:956-207-6351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-12
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1070062471S1302X
TXGMR000237422085R0202X
TX3517722085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology