Organization
SOUTHWEST X-RAY,LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESUS FERNANDO ESCARZAGA RDMS (PRESIDENT)
(915) 833-3500
Entity
Organization
Contact information
Practice address
10501 GATEWAY BLVD W, SUITE 140, EL PASO, TX 79925-7934
(915) 544-7300
(015) 544-7301
Mailing address
PO BOX 220122, EL PASO, TX 79913-2122
(915) 833-3500
(915) 833-3509
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
R28783
TX
293D00000X
Physiological Laboratory
R28783
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1690422-02
—
TX
01
—
FTCXUNV1
MEDICARE ID
—
Enumeration date
11/15/2006
Last updated
12/28/2011
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