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General NPI Number Information
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NPI Number | 1629264734
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Entity Type | Organization
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Legal Business Name | PEDIATRIC CARDIOLOGY ASSO. P.C.
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 303 WILLIAMS AVE SW SUITE 1121
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City | HUNTSVILLE
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State | AL
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Zip | 35801-6012
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Country | US
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Telephone | 256-536-1081
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Fax | 256-536-1082
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Provider Business Mailing Address
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Address Line | 303 WILLIAMS AVE SW SUITE 1121
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City | HUNTSVILLE
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State | AL
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Zip | 35801-6012
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Country | US
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Telephone | 256-536-1081
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Fax | 256-536-1082
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL ISRAEL
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Credential |
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Telephone | 256-536-1081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 12400
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License Number State | AL
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