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NPI Code Detail

MEDICARE: ROCKWALL CARDIO-PULMONARY SERVICES INC

MEDICARE: ROCKWALL CARDIO-PULMONARY SERVICES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM2500XMedical Specialty Clinic/CenterE2484TX

General Provider Information

NPI Number : 1407053234
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROCKWALL CARDIO-PULMONARY SERVICES INC
Provider Business Mailing Address
First Line : PO BOX 9
Second Line :
City : ROCKWALL
State : TX
Zip : 75087-0009
Country : US
Telephone Number : 817-581-6100
Fax Number : 415-795-4434
Provider Business Practice Location Address
First Line : 10400 N CENTRAL EXPY
Second Line :
City : DALLAS
State : TX
Zip : 75231-2297
Country : US
Telephone Number : 214-771-0117
Fax Number : 415-795-4434
Authorized Official
Title or Position : OWNER
Name : LORI SUZZETTE AARON
Credential :
Telephone Number : 817-581-6100
Provider Enumeration Date : 06/27/2007
Last Update Date : 09/18/2023

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