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General NPI Number Information
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NPI Number | 1447953351
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Entity Type | Organization
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Legal Business Name | TEXAS CARDIAC AND VASCULAR SPECIALISTS PA
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Dates
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Enumeration Date | 03/22/2023
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 718 LEXINGTON AVENUE SUITE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78212-4768
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Country | US
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Telephone | 210-420-8671
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Fax | 210-899-1958
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Provider Business Mailing Address
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Address Line | 718 LEXINGTON AVE STE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78212-4790
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Country | US
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Telephone | 210-420-8671
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Fax | 210-899-1958
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | LEAH HAYNES
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Credential |
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Telephone | 726-208-3118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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