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NPI Code Detail

MEDICARE: DALLAS CARDIOLOGY PLLC

MEDICARE: DALLAS CARDIOLOGY PLLC
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
1207RC0000XCardiovascular Disease PhysicianM4527TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11610360OTHERTXWELLCARE
2QMP000003903277OTHERTXMOLINA

General Provider Information

NPI Number : 1720584691
Entity Type Code : Organization
Provider Name (Legal Business Name) : DALLAS CARDIOLOGY PLLC
Provider Business Mailing Address
First Line : 391 E. LAS COLINAS BLVD.
Second Line : STE. 130 #335
City : IRVING
State : TX
Zip : 75039-6225
Country : US
Telephone Number : 972-972-4252
Fax Number : 877-277-3002
Provider Business Practice Location Address
First Line : 560 W MAIN ST STE 205
Second Line :
City : LEWISVILLE
State : TX
Zip : 75057-3604
Country : US
Telephone Number : 972-972-4252
Fax Number : 972-972-4253
Authorized Official
Title or Position : OWNER/MEMBER
Name : DR. MOIZ SHAFIQ
Credential : MD
Telephone Number : 214-924-4073
Provider Enumeration Date : 04/01/2018
Last Update Date : 01/20/2022

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Directions to “DALLAS CARDIOLOGY PLLC ” Practice Location

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