Healthcare Provider Details

I. General information

NPI: 1255642807
Provider Name (Legal Business Name): CARDIO PULMONARY THERAPEUTICS AND DIAGNOSTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2010
Last Update Date: 10/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2210 N VETERANS BLVD SUITE 160
EAGLE PASS TX
78852-6458
US

IV. Provider business mailing address

PO BOX 8160
WACO TX
76714-8160
US

V. Phone/Fax

Practice location:
  • Phone: 830-773-0171
  • Fax: 830-757-0789
Mailing address:
  • Phone: 254-772-6970
  • Fax: 888-775-2609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MS. PAM STRAHL
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 254-772-6970