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General NPI Number Information
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NPI Number | 1497943138
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Entity Type | Organization
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Legal Business Name | TEXAS COAST CARDIOVASCULAR LLC
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 597 W SESAME DR SUITE C
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City | HARLINGEN
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State | TX
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Zip | 78550-8364
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Country | US
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Telephone | 956-412-7503
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Fax | 956-423-0914
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Provider Business Mailing Address
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Address Line | 597 W SESAME DR SUITE C
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City | HARLINGEN
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State | TX
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Zip | 78550-8364
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Country | US
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Telephone | 956-412-7503
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Fax | 956-423-0914
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LISA M DIX-EMPERADOR
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Credential | M.D.
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Telephone | 956-412-7503
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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 | L3283
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License Number State | TX
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