Healthcare Provider Details

I. General information

NPI: 1932739794
Provider Name (Legal Business Name): ALLIED CARDIOVASCULAR ASSITANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 01/21/2020
Certification Date: 01/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 ELIZABETH ST
CORPUS CHRISTI TX
78404-2235
US

IV. Provider business mailing address

4814 LAKE LIVINGSTON DR
CORPUS CHRISTI TX
78413-5139
US

V. Phone/Fax

Practice location:
  • Phone: 361-881-3000
  • Fax:
Mailing address:
  • Phone: 361-813-0160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: AMANDO GARZA
Title or Position: CEO
Credential: LSA
Phone: 361-813-0160