Provider Demographics
NPI:1982783213
Name:SOUTHWEST RHEUMATOLOGY PA
Entity type:Organization
Organization Name:SOUTHWEST RHEUMATOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ATUL
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:SINGHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-288-2600
Mailing Address - Street 1:18601 LBJ FRWY
Mailing Address - Street 2:SUITE 615
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150
Mailing Address - Country:US
Mailing Address - Phone:972-288-2600
Mailing Address - Fax:972-288-8886
Practice Address - Street 1:18601 LBJ FRWY
Practice Address - Street 2:STE 615
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150
Practice Address - Country:US
Practice Address - Phone:972-288-2600
Practice Address - Fax:972-288-8886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0089HMOtherBCBS
TX144680901Medicaid
TX144680901Medicaid