Provider Demographics
NPI:1497003461
Name:SW HOUSTON ACO, LLC
Entity Type:Organization
Organization Name:SW HOUSTON ACO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-733-3160
Mailing Address - Street 1:7850 PARKWOOD CIRCLE DR STE A-7
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-6760
Mailing Address - Country:US
Mailing Address - Phone:832-202-9922
Mailing Address - Fax:866-234-8707
Practice Address - Street 1:7850 PARKWOOD CIRCLE DR STE A-7
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-6760
Practice Address - Country:US
Practice Address - Phone:832-202-9922
Practice Address - Fax:866-234-8707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-26
Last Update Date:2012-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization