1487742722 NPI number — LAREDO CARDIOVASCULAR CONSULTANTS,P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487742722 NPI number — LAREDO CARDIOVASCULAR CONSULTANTS,P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAREDO CARDIOVASCULAR CONSULTANTS,P.A.
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:
1487742722
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/22/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2649
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAREDO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78044-2649
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-726-0033
Provider Business Mailing Address Fax Number:
956-727-5201

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1710 E. SAUNDERS ST.
Provider Second Line Business Practice Location Address:
TOWER B 5TH FLOOR
Provider Business Practice Location Address City Name:
LAREDO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-726-0033
Provider Business Practice Location Address Fax Number:
956-727-5201
Provider Enumeration Date:
10/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CIGARROA
Authorized Official First Name:
RICARDO
Authorized Official Middle Name:
G
Authorized Official Title or Position:
PRESIDEN
Authorized Official Telephone Number:
956-725-1228

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  H3990 , 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)

  • Identifier: 0K99J . This is a "BC/BS PROVIDER #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 142938301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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