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General NPI Number Information
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NPI Number | 1265913255
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Entity Type | Organization
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Legal Business Name | KIDZ CARDIOLOGY, INC
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 10100 E SHANNON WOODS ST STE 108
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City | WICHITA
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State | KS
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Zip | 67226-4104
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Country | US
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Telephone | 316-282-3443
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Fax |
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Provider Business Mailing Address
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Address Line | 10100 E SHANNON WOODS ST STE 108
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City | WICHITA
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State | KS
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Zip | 67226-4104
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Country | US
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Telephone | 316-282-3443
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TUAN NGUYEN
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Credential |
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Telephone | 316-680-4145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State |
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