MEDICARE: SW DL LP

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	207SG0203X	Clinical Molecular Genetics Physician

General Provider Information

NPI Number	:	1356672018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SW DL LP

Provider Business Mailing Address
First Line	:	PO BOX 2240
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27216-2240
Country	:	US
Telephone Number	:	800-222-7566
Fax Number	:

Provider Business Practice Location Address
First Line	:	7400 FANNIN ST
Second Line	:	STE 1212
City	:	HOUSTON
State	:	TX
Zip	:	77054-1920
Country	:	US
Telephone Number	:	713-798-9500
Fax Number	:

Authorized Official
Title or Position	:	CFO EVP TREASURER
Name	:	WILLIAM B HAYES
Credential	:
Telephone Number	:	800-222-7566

Provider Enumeration Date	:	01/20/2010
Last Update Date	:	01/20/2010

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