MEDICARE: SWDIC IMAGING CENTER PARTNERSHIP, LLP

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	261QR0200X	Radiology Clinic/Center	R18642	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	470001463	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MDD0438	OTHER	TX	IDTF WORKERS COMP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	0019CC	OTHER	TX	IDTF BLUE CROSS OF TEXAS

General Provider Information

NPI Number	:	1356347454
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWDIC IMAGING CENTER PARTNERSHIP, LLP

Provider Business Mailing Address
First Line	:	8230 WALNUT HILL LN
Second Line	:	SUITE 100
City	:	DALLAS
State	:	TX
Zip	:	75231-4482
Country	:	US
Telephone Number	:	214-345-6905
Fax Number	:	214-345-2099

Provider Business Practice Location Address
First Line	:	8230 WALNUT HILL LN
Second Line	:	SUITE 100
City	:	DALLAS
State	:	TX
Zip	:	75231-4482
Country	:	US
Telephone Number	:	214-345-4141
Fax Number	:	214-345-2099

Authorized Official
Title or Position	:	DIRECTOR, BUS. SVCS
Name	:	PHILIP COLLINS
Credential	:
Telephone Number	:	214-345-4141

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	05/06/2013

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Directions to “SWDIC IMAGING CENTER PARTNERSHIP, LLP ” Practice Location

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