Healthcare Provider Details

I. General information

NPI: 1821076167
Provider Name (Legal Business Name): CARDIOLOGY CARE CONSULTANTS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 N MESA ST STE 101
EL PASO TX
79902-1118
US

IV. Provider business mailing address

7814 GATEWAY BLVD E
EL PASO TX
79915-1815
US

V. Phone/Fax

Practice location:
  • Phone: 915-542-2352
  • Fax: 915-313-6692
Mailing address:
  • Phone: 915-542-2352
  • Fax: 915-593-8559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH A QUINTANA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 915-542-2352