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General NPI Number Information
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NPI Number | 1497789465
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Entity Type | Organization
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Legal Business Name | SW DIAGNOSTIC CENTER, PA
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 11/09/2017
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Provider Practice Location Address
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Address Line | 88 BRIGGS ST SUITE 110
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City | SAN ANTONIO
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State | TX
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Zip | 78224-1271
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Country | US
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Telephone | 210-921-0902
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Fax | 210-923-8220
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Provider Business Mailing Address
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Address Line | PO BOX 241000
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City | SAN ANTONIO
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State | TX
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Zip | 78224-8000
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Country | US
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Telephone | 210-921-1298
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Fax | 210-923-4001
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VIDYA KAMATH
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Credential | MD
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Telephone | 210-921-1298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | E8607
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License Number State | TX
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