1760610042 NPI number — CARDIOVASCULAR SPECIALISTS OF TEXAS, 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 1760610042 NPI number — CARDIOVASCULAR SPECIALISTS OF TEXAS, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARDIOVASCULAR SPECIALISTS OF TEXAS, 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:
1760610042
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7215 WYOMING SPRINGS DR.
Provider Second Line Business Mailing Address:
BLDG. 1, STE. 100
Provider Business Mailing Address City Name:
ROUND ROCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78681-4311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-807-3180
Provider Business Mailing Address Fax Number:
512-615-0459

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 PARK BEND
Provider Second Line Business Practice Location Address:
BLDG, 2, STE. 300
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78758-5386
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-807-3160
Provider Business Practice Location Address Fax Number:
512-615-0459
Provider Enumeration Date:
06/25/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CHUTICH
Authorized Official First Name:
MARK
Authorized Official Middle Name:
N
Authorized Official Title or Position:
DIRECTOR OF BUSINESS SERVICES
Authorized Official Telephone Number:
512-615-6224

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207UN0901X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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