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General NPI Number Information
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NPI Number | 1194334557
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Entity Type | Organization
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Legal Business Name | ADVANCED HEART AND VASCULAR MEDICINE PLLC
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Dates
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Enumeration Date | 07/30/2020
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 1600 BROOK AVE
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City | WICHITA FALLS
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State | TX
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Zip | 76301-5620
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Country | US
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Telephone | 940-263-3003
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Fax | 940-263-3009
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Provider Business Mailing Address
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Address Line | 1600 BROOK AVE
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City | WICHITA FALLS
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State | TX
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Zip | 76301-5620
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Country | US
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Telephone | 940-263-3003
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Fax | 940-263-3009
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. CHUKWUDI OBIAGWU
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Credential | MD
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Telephone | 940-263-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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