Healthcare Provider Details

I. General information

NPI: 1689788549
Provider Name (Legal Business Name): CARDIO PULMONARY THERAPEUTICS AND DIAGNOSTICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 07/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 S 1ST ST SUITE B
TEMPLE TX
76504-5760
US

IV. Provider business mailing address

PO BOX 8160
WACO TX
76714-8160
US

V. Phone/Fax

Practice location:
  • Phone: 254-771-1968
  • Fax: 254-771-1661
Mailing address:
  • Phone: 254-772-6970
  • Fax: 254-772-5652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: PAM STRAHL
Title or Position: BILLING OPERATIONS MANAGER
Credential:
Phone: 254-772-6970