Healthcare Provider Details

I. General information

NPI: 1356347454
Provider Name (Legal Business Name): SWDIC IMAGING CENTER PARTNERSHIP, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 05/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8230 WALNUT HILL LN SUITE 100
DALLAS TX
75231-4482
US

IV. Provider business mailing address

8230 WALNUT HILL LN SUITE 100
DALLAS TX
75231-4482
US

V. Phone/Fax

Practice location:
  • Phone: 214-345-4141
  • Fax: 214-345-2099
Mailing address:
  • Phone: 214-345-6905
  • Fax: 214-345-2099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberR18642
License Number StateTX

VIII. Authorized Official

Name: PHILIP COLLINS
Title or Position: DIRECTOR, BUS. SVCS
Credential:
Phone: 214-345-4141