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General NPI Number Information
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NPI Number | 1831299122
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Entity Type | Organization
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Legal Business Name | SOUTHWEST MEDICAL ASSOCIATES, INC.
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 04/20/2024
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Provider Practice Location Address
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Address Line | 1207 S BAILEY ST
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City | ELECTRA
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State | TX
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Zip | 76360-3221
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Country | US
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Telephone | 940-495-3981
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 207443
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City | DALLAS
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State | TX
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Zip | 75320-7443
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Country | US
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Telephone | 361-729-0646
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Fax |
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Authorized Official
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Title or Position | VP, OPERATIONS
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Name | MATTHEW BREWINGTON
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Credential |
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Telephone | 361-729-0646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State | TX
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