Organization
SOUTHWEST MEDICAL IMAGING PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA HERNANDEZ RN (OFFICE MANAGER)
(432) 570-1421
Entity
Organization
Contact information
Practice address
2200 W ILLINOIS AVE, MIDLAND, TX 79701-6407
(432) 570-1421
(432) 570-1427
Mailing address
PO BOX 5500, MIDLAND, TX 79704-5500
(432) 570-1421
(432) 570-1427
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00T02K
SWMI BCBS PROV GRP #
TX
05
—
112619501
—
TX
01
—
A001
SWMI TRICARE GRP PROV #
TX
Enumeration date
02/21/2006
Last updated
01/27/2014
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