1437357357 NPI number — CARDIOVASCULAR INSTITUTE PA

Table of content: (NPI 1437357357)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437357357 NPI number — CARDIOVASCULAR INSTITUTE PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARDIOVASCULAR INSTITUTE PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437357357
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
355 SCHOOL STREET
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
TOMBALL
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77375
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-357-5700
Provider Business Mailing Address Fax Number:
281-357-8822

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
355 SCHOOL STREET
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
TOMBALL
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77375
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-357-5700
Provider Business Practice Location Address Fax Number:
281-357-8822
Provider Enumeration Date:
07/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MUTTIANA
Authorized Official First Name:
DALJIT
Authorized Official Middle Name:
SINGH
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
281-357-5700

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5507022 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0020MW . This is a "BCBS OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 133664601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com