Provider Demographics
NPI:1225137078
Name:SOUTHWESTERN ULTRASOUND INC.
Entity Type:Organization
Organization Name:SOUTHWESTERN ULTRASOUND INC.
Other - Org Name:DESERT IMAGING SERVICES, LP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIZPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-577-0100
Mailing Address - Street 1:122 W CASTELLANO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-6170
Mailing Address - Country:US
Mailing Address - Phone:915-577-0100
Mailing Address - Fax:915-400-0427
Practice Address - Street 1:122 W CASTELLANO DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-6170
Practice Address - Country:US
Practice Address - Phone:915-577-0100
Practice Address - Fax:915-400-0427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX095070101Medicaid
TX227835OtherMQSA
TXCJ5870OtherRAILROAD MEDICARE
TXM00747OtherMAMMOGRAPHY CERTIFICATION
TX0092AXMedicare PIN