1437457686 NPI number — NORTHWEST CARDIOVASCULAR CLINIC, PA

Table of content: (NPI 1437457686)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437457686 NPI number — NORTHWEST CARDIOVASCULAR CLINIC, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHWEST CARDIOVASCULAR CLINIC, 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:
1437457686
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/26/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16407 LAKEWOOD FIELD DR
Provider Second Line Business Mailing Address:
LAKEWOOD FIELD DRIVE
Provider Business Mailing Address City Name:
TOMBALL
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77377-8789
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-473-8854
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18220 TOMBALL PKWY STE 230
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77070-4350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-807-5252
Provider Business Practice Location Address Fax Number:
281-477-7452
Provider Enumeration Date:
03/10/2011

Additional Information

Authorized Official

Authorized Official Last Name:
DAIRYWALA
Authorized Official First Name:
ISMAIL
Authorized Official Middle Name:
TAHERALI
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
281-807-5253

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  L0114 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com