Healthcare Provider Details

I. General information

NPI: 1174284616
Provider Name (Legal Business Name): SBAH CARDIOLOGY ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2022
Last Update Date: 01/06/2022
Certification Date: 01/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11920 ASTORIA BLVD STE 340
HOUSTON TX
77089-6155
US

IV. Provider business mailing address

980 N MICHIGAN AVE STE 1998
CHICAGO IL
60611-7504
US

V. Phone/Fax

Practice location:
  • Phone: 281-506-8720
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: VANCE VANIER
Title or Position: PRESIDENT
Credential: MD
Phone: 312-273-4750