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General NPI Number Information
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NPI Number | 1164734059
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR SPECIALISTS OF TEXAS
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Dates
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Enumeration Date | 07/08/2010
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Last Update Date | 07/08/2010
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Provider Practice Location Address
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Address Line | 206 CR 340-A BLDG. 4, STE. A
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City | BURNET
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State | TX
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Zip | 78611
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Country | US
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Telephone | 512-756-0900
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Fax | 512-756-0905
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Provider Business Mailing Address
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Address Line | 7000 N MOPAC EXPY SECOND FLOOR
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City | AUSTIN
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State | TX
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Zip | 78731-3027
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Country | US
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Telephone | 512-615-6200
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MARK CHUTICH
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Credential |
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Telephone | 512-615-6224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology 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 | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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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 | 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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