Healthcare Provider Details

I. General information

NPI: 1871263905
Provider Name (Legal Business Name): UCARDIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 09/20/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3713 MEREDITH ST
AUSTIN TX
78703-2020
US

IV. Provider business mailing address

3713 MEREDITH ST
AUSTIN TX
78703-2020
US

V. Phone/Fax

Practice location:
  • Phone: 214-205-8789
  • Fax:
Mailing address:
  • Phone: 214-205-8789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC3500X
TaxonomyCardiac Rehabilitation Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID JACKSON
Title or Position: EXECUTIVE VICE PRESIDENT
Credential: PHD
Phone: 949-246-0875