Healthcare Provider Details

I. General information

NPI: 1295782852
Provider Name (Legal Business Name): NORTH TEXAS HEART CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 03/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8440 WALNUT HILL LN SUITE 700
DALLAS TX
75231-3833
US

IV. Provider business mailing address

8440 WALNUT HILL LN SUITE 700
DALLAS TX
75231-3833
US

V. Phone/Fax

Practice location:
  • Phone: 214-361-3300
  • Fax: 214-361-3437
Mailing address:
  • Phone: 214-361-3300
  • Fax: 214-361-3437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. STACIE E PRASIFKA
Title or Position: CEO
Credential: CPA
Phone: 214-361-3404