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NPI Code Detail

MEDICARE: HEART CENTER OF NORTH TEXAS, PA

MEDICARE: HEART CENTER OF NORTH TEXAS, PA
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
1207RC0001XClinical Cardiac Electrophysiology Physician
2207RI0011XInterventional Cardiology Physician
3207RC0000XCardiovascular Disease Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100455KOTHERTXBLUE CROSS BLUE SHIELD
25930155OTHERTXAETNA GROUP
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396762357
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEART CENTER OF NORTH TEXAS, PA
Provider Business Mailing Address
First Line : 1017 12TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3915
Country : US
Telephone Number : 817-334-2800
Fax Number : 817-820-0094
Provider Business Practice Location Address
First Line : 1017 12TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3915
Country : US
Telephone Number : 817-334-2800
Fax Number : 817-820-0094
Authorized Official
Title or Position : ADMINISTRATOR
Name : SYDNEY MADDEN
Credential :
Telephone Number : 817-334-2800
Provider Enumeration Date : 07/16/2006
Last Update Date : 06/22/2021

Similar Medicare Providers

1619927373 — GEORGE SOUHEL KHAMMAR MD
Practice Location Address:
1017 12TH AVE
FORT WORTH, TX
76104-3915
Practice Phone: 817-334-2800
Practice Fax: 817-820-0094
1104876879 — DR. HENRY P LOBSTEIN M.D.
Practice Location Address:
1017 12TH AVE
FORT WORTH, TX
76104-3915
Practice Phone: 817-334-2800
Practice Fax: 817-336-1954
1568413417 — AMIR ZULFIKAR MALIK MD
Practice Location Address:
1017 12TH AVE
FORT WORTH, TX
76104-3915
Practice Phone: 817-334-2800
Practice Fax: 817-820-0094
1952352825 — NASIM AKHTAR M.D.
Practice Location Address:
1017 12TH AVE
FORT WORTH, TX
76104-3915
Practice Phone: 817-334-2800
Practice Fax: 817-336-1954
1255401543 — JOE D CROWLEY RPH
Practice Location Address:
1001 12TH AVE , SUITE 200
FORT WORTH, TX
76104-3915
Practice Phone: 817-850-2090
Practice Fax: 817-850-2095
1396936357 — DR. FARHAN ALI M.D.
Practice Location Address:
1017 12TH AVE
FORT WORTH, TX
76104-3915
Practice Phone: 817-334-2800
Practice Fax: 817-820-0094

Directions to “HEART CENTER OF NORTH TEXAS, PA ” Practice Location

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