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General NPI Number Information
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NPI Number | 1023221876
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Entity Type | Organization
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Legal Business Name | HOUSTON CARDIAC ASSOCIATION, PA
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 03/16/2012
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Provider Practice Location Address
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Address Line | 10480 MAIN ST
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City | HOUSTON
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State | TX
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Zip | 77025-5500
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Country | US
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Telephone | 713-599-1144
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Fax | 713-599-1199
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Provider Business Mailing Address
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Address Line | 10480 MAIN ST
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City | HOUSTON
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State | TX
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Zip | 77025-5500
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Country | US
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Telephone | 713-599-1144
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Fax | 713-599-1199
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Authorized Official
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Title or Position | PHYSICIAN/EXECUTIVE DIRECTOR
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Name | DR. BAXTER DELWORTH MONTGOMERY
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Credential | M.D.
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Telephone | 713-599-1144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | H9549
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License Number State | TX
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