=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487759494
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BAY AREA CARDIOLOGY PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2006
-----------------------------------------------------
Last Update Date | 11/06/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | #2 PROFESSIONAL PARK DR
-----------------------------------------------------
City | WEBSTER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77598
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-332-0577
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | #2 PROFESSIONAL PARK DR
-----------------------------------------------------
City | WEBSTER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77598
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-332-0577
-----------------------------------------------------
Fax | 281-332-8790
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT PHYSICIAN
-----------------------------------------------------
Name | DR. HAROLD M ROSENTHAL
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 281-332-0577
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | F5019
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------