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General NPI Number Information
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NPI Number | 1699181784
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Entity Type | Organization
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Legal Business Name | HEART & LUNG CENTER OF SOUTHEAST TEXAS PA
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 21212 NORTHWEST FWY STE 265
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City | CYPRESS
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State | TX
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Zip | 77429-5883
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Country | US
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Telephone | 281-653-9123
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Fax | 281-653-9175
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Provider Business Mailing Address
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Address Line | 21212 NORTHWEST FWY STE 265
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City | CYPRESS
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State | TX
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Zip | 77429-5883
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Country | US
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Telephone | 281-653-9123
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Fax | 281-653-9175
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Authorized Official
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Title or Position | CEO
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Name | ANIL GOLI
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Credential |
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Telephone | 281-653-9123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 36561
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | N7264
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License Number State | TX
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