Basic Information
| Provider Information | |||||||||
| NPI: | 1467436105 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUTHWEST MRI LP | ||||||||
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| OtherOrganizationName: | SUGARLAND MRI | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8126 | ||||||||
| Address2: | |||||||||
| City: | SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773878126 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1211 HIGHWAY 6 | ||||||||
| Address2: | |||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774784940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134321100 | ||||||||
| FaxNumber: | 7134320221 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2005 | ||||||||
| LastUpdateDate: | 08/01/2007 | ||||||||
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| AuthorizedOfficialLastName: | SNOW, JR. | ||||||||
| AuthorizedOfficialFirstName: | JUDSON | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | AUTHORIZED REP | ||||||||
| AuthorizedOfficialTelephone: | 7134321100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.