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General NPI Number Information
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NPI Number | 1407065543
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Entity Type | Organization
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Legal Business Name | HEART CENTER OF NORTH TEXAS, PA
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 06/22/2021
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Provider Practice Location Address
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Address Line | 351 E TARLETON ST
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City | STEPHENVILLE
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State | TX
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Zip | 76401-3511
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Country | US
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Telephone | 817-334-2800
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Fax | 817-820-0094
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Provider Business Mailing Address
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Address Line | 1017 12TH AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-3915
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Country | US
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Telephone | 817-334-2800
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Fax | 817-820-0094
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SYDNEY MADDEN
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Credential |
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Telephone | 817-334-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology 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 | 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 #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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