Healthcare Provider Details

I. General information

NPI: 1669455143
Provider Name (Legal Business Name): BT HEART AND VASCULAR CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 10/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 W STUART DR
GALAX VA
24333-2605
US

IV. Provider business mailing address

812 W STUART DR
GALAX VA
24333-2605
US

V. Phone/Fax

Practice location:
  • Phone: 276-238-3318
  • Fax: 276-239-4204
Mailing address:
  • Phone: 276-238-3318
  • Fax: 276-239-4204

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: DR. BEHZAD TAGHIZADEH
Title or Position: DIRECTOR
Credential: MD
Phone: 336-765-2500