MEDICARE: BELLAIRE CARDIOVASCULAR CARE 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
1	305S00000X	Point of Service	H3275	TX

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	:	1497944581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELLAIRE CARDIOVASCULAR CARE PA

Provider Business Mailing Address
First Line	:	12112 BELLAIRE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-2315
Country	:	US
Telephone Number	:	281-988-6462
Fax Number	:	281-988-7462

Provider Business Practice Location Address
First Line	:	12112 BELLAIRE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-2315
Country	:	US
Telephone Number	:	281-988-6462
Fax Number	:	281-988-7462

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. LOI PHI NGUYEN
Credential	:	MD
Telephone Number	:	281-988-6462

Provider Enumeration Date	:	10/15/2007
Last Update Date	:	12/13/2012

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