Healthcare Provider Details

I. General information

NPI: 1831740802
Provider Name (Legal Business Name): PREMIER HEART CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2019
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 W STATE HIGHWAY 114 STE 130
GRAPEVINE TX
76051-8649
US

IV. Provider business mailing address

PO BOX 92552
SOUTHLAKE TX
76092-0552
US

V. Phone/Fax

Practice location:
  • Phone: 682-214-3486
  • Fax: 682-214-3470
Mailing address:
  • Phone: 817-379-3251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. TRIEU HO
Title or Position: PRESIDENT
Credential: MD
Phone: 817-437-3711