MEDICARE: HARWIN DIAGNOSTICS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085U0001X	Diagnostic Ultrasound Physician

General Provider Information

NPI Number	:	1346425642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARWIN DIAGNOSTICS INC

Provider Business Mailing Address
First Line	:	7457 HARWIN DR STE 210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-2024
Country	:	US
Telephone Number	:	713-333-9200
Fax Number	:	713-333-9202

Provider Business Practice Location Address
First Line	:	7457 HARWIN DR STE 210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-2024
Country	:	US
Telephone Number	:	713-333-9200
Fax Number	:	713-333-9202

Authorized Official
Title or Position	:	OWNER
Name	:	MR. KONSTANTIN KHOMIAKOV
Credential	:
Telephone Number	:	713-333-9200

Provider Enumeration Date	:	01/04/2008
Last Update Date	:	01/04/2008

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