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NPI Code Detail

MEDICARE: CARDIAC AND VASCULAR CENTER, P.C.

MEDICARE: CARDIAC AND VASCULAR CENTER, P.C.
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
1207R00000XInternal Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1K4351OTHERTXLICENSE

General Provider Information

NPI Number : 1548423403
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARDIAC AND VASCULAR CENTER, P.C.
Provider Business Mailing Address
First Line : 2704 N GALLOWAY AVE
Second Line : SUITE 103
City : MESQUITE
State : TX
Zip : 75150-6378
Country : US
Telephone Number : 972-279-3500
Fax Number : 972-279-3505
Provider Business Practice Location Address
First Line : 2704 N GALLOWAY AVE
Second Line : SUITE 103
City : MESQUITE
State : TX
Zip : 75150-6378
Country : US
Telephone Number : 972-279-3500
Fax Number : 972-279-3505
Authorized Official
Title or Position : PRESIDENT
Name : DR. MAHMOOD ALI
Credential : M.D.
Telephone Number : 972-279-3500
Provider Enumeration Date : 07/09/2008
Last Update Date : 08/22/2008

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Directions to “CARDIAC AND VASCULAR CENTER, P.C. ” Practice Location

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