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General NPI Number Information
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NPI Number | 1538835533
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Entity Type | Organization
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Legal Business Name | AXIS CARDIOVASCULAR, PLLC
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Dates
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Enumeration Date | 08/19/2021
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 4871 WILLIAMS DR BLDG. 1 SUITE 105
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City | GEORGETOWN
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State | TX
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Zip | 78633-2309
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Country | US
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Telephone | 407-404-0210
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Fax |
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Provider Business Mailing Address
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Address Line | 4871 WILLIAMS DR BLDG. 1 SUITE 105
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City | GEORGETOWN
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State | TX
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Zip | 78633-2309
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Country | US
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Telephone | 512-240-5025
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Fax | 833-913-2545
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Authorized Official
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Title or Position | DIRECTOR
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Name | FARAZ KURESHI
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Credential | MD, MSC
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Telephone | 512-240-5025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine 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 | 207R00000X
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Taxonomy Name | Internal Medicine 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 | 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 #4
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Taxonomy Code | 207RM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207RA0002X
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Taxonomy Name | Adult Congenital Heart Disease Physician
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License Number |
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License Number State |
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Taxonomy #7
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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 #8
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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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