MEDICARE: CARDIOLOGY SPECIALISTS OF NORTH TEXAS, PLLC

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
1	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1770424798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOLOGY SPECIALISTS OF NORTH TEXAS, PLLC

Provider Business Mailing Address
First Line	:	2000 HEALTH PARK DR
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-4692
Country	:	US
Telephone Number	:	615-373-7406
Fax Number	:

Provider Business Practice Location Address
First Line	:	1102 N GALLOWAY AVE
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75149-2436
Country	:	US
Telephone Number	:	972-566-4822
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	NICHOLAS R JOHNSON
Credential	:
Telephone Number	:	972-401-9807

Provider Enumeration Date	:	04/03/2026
Last Update Date	:	04/03/2026

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