MEDICARE: HEART CLINIC, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	207RC0001X	Clinical Cardiac Electrophysiology Physician
2	207RI0011X	Interventional Cardiology Physician
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
4	363A00000X	Physician Assistant
5	363L00000X	Nurse Practitioner
6	207RC0000X	Cardiovascular Disease Physician	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CR1177	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	00TS23	OTHER	TX	BCBS OF TEXAS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437153244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART CLINIC, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 3046
Second Line	:
City	:	MALVERN
State	:	PA
Zip	:	19355-0746
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 E RIDGE RD
Second Line	:	SUITE 300
City	:	MCALLEN
State	:	TX
Zip	:	78503-1506
Country	:	US
Telephone Number	:	956-630-5522
Fax Number	:

Authorized Official
Title or Position	:	VP
Name	:	TODD EVANS
Credential	:
Telephone Number	:	610-768-3300

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	06/26/2019

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Directions to “HEART CLINIC, PLLC ” Practice Location

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