Basic Information
| Provider Information | |||||||||
| NPI: | 1972045243 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARDIOVASCULAR CENTER OF TEXAS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1125 RAINTREE CIR STE 200 | ||||||||
| Address2: | |||||||||
| City: | ALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750135289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4688988402 | ||||||||
| FaxNumber: | 4696401033 | ||||||||
| Practice Location | |||||||||
| Address1: | 1125 RAINTREE CIR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750134900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4688988400 | ||||||||
| FaxNumber: | 4698988401 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2016 | ||||||||
| LastUpdateDate: | 03/14/2022 | ||||||||
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| AuthorizedOfficialLastName: | CADENHEAD | ||||||||
| AuthorizedOfficialFirstName: | LEIGH | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 4698988402 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.