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General NPI Number Information
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NPI Number | 1841452414
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Entity Type | Organization
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Legal Business Name | SOUTHWEST DIAGNOSTICS
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Dates
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Enumeration Date | 06/25/2008
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 4435 GREEN TEE DR
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City | BAYTOWN
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State | TX
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Zip | 77521-3059
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Country | US
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Telephone | 281-424-2253
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 757
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City | BAYTOWN
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State | TX
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Zip | 77522-0757
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Country | US
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Telephone | 281-424-2253
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SALLY J LINDBERG
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Credential |
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Telephone | 281-424-2253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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