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General NPI Number Information
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NPI Number | 1811290885
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Entity Type | Organization
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Legal Business Name | SOUTHWESTERN RADIOLOGY ASSOCIATES, P.A.
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Dates
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Enumeration Date | 12/14/2010
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Last Update Date | 12/14/2010
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Provider Practice Location Address
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Address Line | 2105 LAKE ESTATES DR
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City | ROCKWALL
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State | TX
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Zip | 75032-7007
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Country | US
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Telephone | 214-303-9902
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Fax | 972-210-7002
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Provider Business Mailing Address
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Address Line | 2105 LAKE ESTATES DR
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City | ROCKWALL
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State | TX
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Zip | 75032-7007
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Country | US
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Telephone | 214-303-9902
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Fax | 972-210-7002
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS VARGHESE
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Credential | M.D.
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Telephone | 214-303-9902
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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 | L8990
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License Number State | TX
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