Provider Demographics
NPI:1306036702
Name:SBM DIAGNOSTICS, INC.
Entity Type:Organization
Organization Name:SBM DIAGNOSTICS, INC.
Other - Org Name:SOUTHWEST DIAGNOSTICS AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAGOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-420-1481
Mailing Address - Street 1:1720 DRYDEN RD # 226
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2402
Mailing Address - Country:US
Mailing Address - Phone:800-420-1481
Mailing Address - Fax:
Practice Address - Street 1:1720 DRYDEN RD # 226
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2402
Practice Address - Country:US
Practice Address - Phone:800-420-1481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NOT NECESSARY291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory