Healthcare Provider Details

I. General information

NPI: 1427265859
Provider Name (Legal Business Name): CARDIAC ELECTROPHYSIOLOGY CONSULTANTS OF SOUTH TEXAS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7950 FLOYD CURL DR SUITE 803
SAN ANTONIO TX
78229-3919
US

IV. Provider business mailing address

PO BOX 782071
SAN ANTONIO TX
78278-2071
US

V. Phone/Fax

Practice location:
  • Phone: 210-615-9500
  • Fax: 210-615-9600
Mailing address:
  • Phone: 210-615-9500
  • Fax: 210-615-9600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LAWRENCE EDWARD WIDMAN
Title or Position: PRESIDENT
Credential: MD PHD
Phone: 210-615-9500