MEDICARE: HEART TO HEART CARDIOVASCULAR ASSOCIATES

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	L2126	TX
2	207RI0011X	Interventional Cardiology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P00209257	OTHER	TX	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2628425	OTHER	TX	CIGNA HMO
2	4130361	OTHER	TX	BCBS BLUE LINK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	8R5784	OTHER	TX	BCBS
5	1114931573	OTHER	TX	NPI TYPE 1
7	7859289	OTHER	TX	AETNA

General Provider Information

NPI Number	:	1538304613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART TO HEART CARDIOVASCULAR ASSOCIATES

Provider Business Mailing Address
First Line	:	409 RUSSELL BLVD STE A
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1248
Country	:	US
Telephone Number	:	936-560-4327
Fax Number	:	866-927-4221

Provider Business Practice Location Address
First Line	:	409 RUSSELL BLVD STE A
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1248
Country	:	US
Telephone Number	:	936-560-4327
Fax Number	:	888-927-4221

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JANICE LOUDENSLAGER
Credential	:
Telephone Number	:	936-560-4327

Provider Enumeration Date	:	12/03/2008
Last Update Date	:	05/16/2023

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Directions to “HEART TO HEART CARDIOVASCULAR ASSOCIATES ” Practice Location

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