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General NPI Number Information
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NPI Number | 1245233501
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Entity Type | Organization
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Legal Business Name | PHYSICIANS CARDIOVASCULAR DIAGNOSTIC CENTER, L.L.P.
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | 2955 HARRISON ST STE 300
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City | BEAUMONT
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State | TX
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Zip | 77702-1157
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Country | US
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Telephone | 409-924-3996
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Fax | 409-924-3916
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Provider Business Mailing Address
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Address Line | 2955 HARRISON ST STE 300
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City | BEAUMONT
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State | TX
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Zip | 77702-1157
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Country | US
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Telephone | 409-924-3996
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Fax | 409-924-3916
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. THOMAS RANDOLPH LOMBARDO
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Credential | M.D.
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Telephone | 409-924-3996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | R25618
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License Number State | TX
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