Healthcare Provider Details

I. General information

NPI: 1881661411
Provider Name (Legal Business Name): SOUTHWEST MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 S RANCHO
LAS VEGAS NV
89102
US

IV. Provider business mailing address

PO BOX 15645
LAS VEGAS NV
89114-5645
US

V. Phone/Fax

Practice location:
  • Phone: 702-877-8600
  • Fax:
Mailing address:
  • Phone: 702-242-7786
  • Fax: 702-240-8790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HOWARD ARNOLD TISCHLER
Title or Position: DIAGNOSTIC RADIOLOGY MD
Credential: MD
Phone: 702-759-8778