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General NPI Number Information
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NPI Number | 1275173379
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Entity Type | Organization
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Legal Business Name | HOUSTON CARDIOTHORACIC AND VEIN SURGEONS, PLLC
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 1900 NORTH LOOP W STE 180
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City | HOUSTON
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State | TX
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Zip | 77018-8151
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Country | US
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Telephone | 281-888-0809
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Fax | 877-559-7682
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Provider Business Mailing Address
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Address Line | 25511 BUDDE RD STE 2502
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City | THE WOODLANDS
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State | TX
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Zip | 77380-2388
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Country | US
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Telephone | 281-888-0809
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Fax | 877-559-7682
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Authorized Official
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Title or Position | OWNER
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Name | JON CECIL M WALKES
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Credential | MD
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Telephone | 281-888-0809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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