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General NPI Number Information
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NPI Number | 1437457686
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Entity Type | Organization
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Legal Business Name | NORTHWEST CARDIOVASCULAR CLINIC, PA
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Dates
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Enumeration Date | 03/10/2011
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 18220 TOMBALL PKWY STE 230
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City | HOUSTON
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State | TX
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Zip | 77070-4350
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Country | US
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Telephone | 281-807-5252
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Fax | 281-477-7452
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Provider Business Mailing Address
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Address Line | 16407 LAKEWOOD FIELD DR LAKEWOOD FIELD DRIVE
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City | TOMBALL
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State | TX
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Zip | 77377-8789
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Country | US
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Telephone | 832-473-8854
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ISMAIL TAHERALI DAIRYWALA
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Credential |
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Telephone | 281-807-5253
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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 | L0114
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License Number State | TX
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