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General NPI Number Information
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NPI Number | 1326476037
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Entity Type | Organization
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Legal Business Name | TRICITIES CARDIOLOGY
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 10/16/2013
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Provider Practice Location Address
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Address Line | 4100 HERITAGE AVE SUITE 102
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City | GRAPEVINE
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State | TX
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Zip | 76051-5714
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Country | US
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Telephone | 469-251-0589
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 534
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City | COLLEYVILLE
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State | TX
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Zip | 76034-0534
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AMYN MALIK
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Credential | MD,FACC
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Telephone | 469-251-0589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | P7307
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License Number State | TX
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