Healthcare Provider Details

I. General information

NPI: 1538282546
Provider Name (Legal Business Name): HEART OF TEXAS MEDICAL ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2026 S BRIDGE ST
BRADY TX
76825-7421
US

IV. Provider business mailing address

PO BOX 590
BRADY TX
76825-0590
US

V. Phone/Fax

Practice location:
  • Phone: 325-792-1300
  • Fax: 325-792-1155
Mailing address:
  • Phone: 325-792-1300
  • Fax: 325-792-1155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberJ7815
License Number StateTX

VIII. Authorized Official

Name: JEFFRY PATRICK MAYS
Title or Position: PRESIDENT
Credential: MD
Phone: 325-792-1300