Healthcare Provider Details

I. General information

NPI: 1902266208
Provider Name (Legal Business Name): NORTH TEXAS COMPREHENSIVE CARDIOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2016
Last Update Date: 03/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 N HIGHLAND AVE SUITE 120
SHERMAN TX
75092-7377
US

IV. Provider business mailing address

425 N HIGHLAND AVE SUITE 120
SHERMAN TX
75092-7377
US

V. Phone/Fax

Practice location:
  • Phone: 903-361-7869
  • Fax: 903-598-7726
Mailing address:
  • Phone: 903-361-7869
  • Fax: 903-598-7726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: THERESA M ULMER
Title or Position: OFFICE MANAGER
Credential:
Phone: 903-821-6177