MEDICARE: TEXAS HEART CARE

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
1	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1073551636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS HEART CARE

Provider Business Mailing Address
First Line	:	9 MEDICAL PKWY
Second Line	:	PLAZA 4, SUITE 207
City	:	DALLAS
State	:	TX
Zip	:	75234-7858
Country	:	US
Telephone Number	:	972-488-9656
Fax Number	:	972-488-9636

Provider Business Practice Location Address
First Line	:	9 MEDICAL PKWY
Second Line	:	PLAZA 4, SUITE 207
City	:	DALLAS
State	:	TX
Zip	:	75234-7858
Country	:	US
Telephone Number	:	972-488-9656
Fax Number	:	972-488-9636

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CHERYL LAINE
Credential	:
Telephone Number	:	972-488-9656

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	04/22/2008

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Directions to “TEXAS HEART CARE ” Practice Location

Language	Start Address	Practice Location

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