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General NPI Number Information
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NPI Number | 1609804301
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Entity Type | Organization
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Legal Business Name | TEXAS CARDIOVASCULAR CONSULTANTS PA
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 03/23/2009
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Provider Practice Location Address
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Address Line | 5301 RIATA PARK CT BLDG D, SUITE 200
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City | AUSTIN
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State | TX
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Zip | 78727-3438
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Country | US
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Telephone | 512-617-6000
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Fax | 512-615-0459
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Provider Business Mailing Address
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Address Line | 5301 RIATA PARK CT BLDG D, SUITE 200
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City | AUSTIN
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State | TX
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Zip | 78727-3438
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Country | US
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Telephone | 512-617-6000
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Fax | 512-615-0459
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Authorized Official
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Title or Position | DIRECTOR, BUSINESS SERVICES
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Name | MS. MARY TYPHAIR
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Credential |
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Telephone | 512-615-6218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | TX
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Taxonomy #2
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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 | TX
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Taxonomy #3
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear 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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State | TX
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