MEDICARE: SOUTHWEST MRI LP

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	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1467436105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST MRI LP

Provider Business Mailing Address
First Line	:	PO BOX 8126
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77387-8126
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1211 HIGHWAY 6
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-4940
Country	:	US
Telephone Number	:	713-432-1100
Fax Number	:	713-432-0221

Authorized Official
Title or Position	:	AUTHORIZED REP
Name	:	DR. JUDSON H SNOW, JR.
Credential	:
Telephone Number	:	713-432-1100

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	08/01/2007

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