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General NPI Number Information
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NPI Number | 1386632115
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Entity Type | Organization
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Legal Business Name | CLINIC FOR CARDIOVASCULAR CARE
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 09/12/2018
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Provider Practice Location Address
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Address Line | 400 HOLDERRIETH BLVD STE 104
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City | TOMBALL
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State | TX
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Zip | 77375-4543
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Country | US
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Telephone | 281-251-2000
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Fax | 281-378-5918
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Provider Business Mailing Address
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Address Line | 400 HOLDERRIETH BLVD STE 104
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City | TOMBALL
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State | TX
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Zip | 77375-4552
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Country | US
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Telephone | 281-255-2000
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Fax | 281-378-5918
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. WAQAR A KHAN
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Credential | MD
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Telephone | 281-255-2000
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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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Taxonomy #2
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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