Basic Information
| Provider Information | |||||||||
| NPI: | 1538327135 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUTHWEST IMAGING AND INTERVENTIONAL SPECILASITS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7515 GREENVILLE AVE | ||||||||
| Address2: | SUITE 710 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752313831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143638378 | ||||||||
| FaxNumber: | 2143630720 | ||||||||
| Practice Location | |||||||||
| Address1: | 8501 WADE BLVD | ||||||||
| Address2: | |||||||||
| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750345894 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146183420 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2008 | ||||||||
| LastUpdateDate: | 05/30/2008 | ||||||||
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| AuthorizedOfficialLastName: | BARR | ||||||||
| AuthorizedOfficialFirstName: | PATRICK | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2143638378 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | G4814 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.