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NPI Code Detail

MEDICARE: EAST TEXAS CARDIOLOGY P.A.

MEDICARE: EAST TEXAS CARDIOLOGY P.A.
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DF0398OTHERRAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30070NTOTHERBCBS

General Provider Information

NPI Number : 1073550208
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAST TEXAS CARDIOLOGY P.A.
Provider Business Mailing Address
First Line : PO BOX 36728
Second Line :
City : HOUSTON
State : TX
Zip : 77236-6728
Country : US
Telephone Number : 713-651-1787
Fax Number : 713-651-1791
Provider Business Practice Location Address
First Line : 2000 CRAWFORD ST
Second Line : 1403
City : HOUSTON
State : TX
Zip : 77002-9000
Country : US
Telephone Number : 713-651-1787
Fax Number : 713-651-1791
Authorized Official
Title or Position : MEMBER
Name : DR. ANWAR AHMAD
Credential : M.D.
Telephone Number : 713-651-1787
Provider Enumeration Date : 05/31/2006
Last Update Date : 01/20/2011

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Directions to “EAST TEXAS CARDIOLOGY P.A. ” Practice Location

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