MEDICARE: CARDIOVASCULAR SPECIALISTS OF TEXAS, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RC0000X	Cardiovascular Disease Physician
2	207UN0901X	Nuclear Cardiology Physician
3	207RI0011X	Interventional Cardiology Physician

General Provider Information

NPI Number	:	1003044777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOVASCULAR SPECIALISTS OF TEXAS, P.A.

Provider Business Mailing Address
First Line	:	5301 RIATA PARK COURT
Second Line	:	BLDG. D, STE. 200
City	:	AUSTIN
State	:	TX
Zip	:	78727-3438
Country	:	US
Telephone Number	:	512-617-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	702 E. CALTON RD.
Second Line	:	SUITE A
City	:	LAREDO
State	:	TX
Zip	:	78041-3988
Country	:	US
Telephone Number	:	512-617-6000
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATIVE ASSISTANT
Name	:	MARK CHUTICH
Credential	:
Telephone Number	:	512-615-6224

Provider Enumeration Date	:	07/01/2009
Last Update Date	:	07/01/2009

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