Basic Information
| Provider Information | |||||||||
| NPI: | 1639314511 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEART AND VASCULAR CLINIC, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 844 CENTRAL BLVD | ||||||||
| Address2: | SUITE 170 | ||||||||
| City: | BROWNSVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785207552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566985613 | ||||||||
| FaxNumber: | 9566984953 | ||||||||
| Practice Location | |||||||||
| Address1: | 844 CENTRAL BLVD | ||||||||
| Address2: | SUITE 170 | ||||||||
| City: | BROWNSVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785207552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566985613 | ||||||||
| FaxNumber: | 9566984953 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2008 | ||||||||
| LastUpdateDate: | 12/08/2008 | ||||||||
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| AuthorizedOfficialLastName: | ALFAYOUMI | ||||||||
| AuthorizedOfficialFirstName: | FADI | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9566985613 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | M3448 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.