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General NPI Number Information
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NPI Number | 1114348380
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Entity Type | Organization
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Legal Business Name | ST LOUIS HEART AND VASCULAR P.C.
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Dates
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Enumeration Date | 12/13/2013
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 11155 DUNN RD SUITE 304E
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City | SAINT LOUIS
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State | MO
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Zip | 63136-6150
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Country | US
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Telephone | 314-741-0911
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Fax | 314-653-3676
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Provider Business Mailing Address
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Address Line | 11155 DUNN RD SUITE 304E
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City | SAINT LOUIS
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State | MO
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Zip | 63136-6150
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Country | US
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Telephone | 314-741-0911
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Fax | 314-653-3676
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Authorized Official
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Title or Position | ASSOCIATE VP
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Name | ALLEN SCHNEIDER
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Credential |
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Telephone | 314-741-0911
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 132113
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License Number State | MO
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