MEDICARE: MR. RALPH WILLIAM SWEET JR. R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	581046	TX

General Provider Information

NPI Number	:	1083772354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RALPH WILLIAM SWEET JR. R.N.

Provider Business Mailing Address
First Line	:	15019 OAK BRIAR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-5497
Country	:	US
Telephone Number	:	630-699-8523
Fax Number	:

Provider Business Practice Location Address
First Line	:	15019 OAK BRIAR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-5497
Country	:	US
Telephone Number	:	630-699-8523
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	07/11/2008

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