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NPI Code Detail

MEDICARE: PERMIAN CARDIOLOGY ASSOCIATES

MEDICARE: PERMIAN CARDIOLOGY 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
1207RC0000XCardiovascular Disease Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000K51VOTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1760527139
Entity Type Code : Organization
Provider Name (Legal Business Name) : PERMIAN CARDIOLOGY ASSOCIATES
Provider Business Mailing Address
First Line : 2405 W MISSOURI AVE
Second Line :
City : MIDLAND
State : TX
Zip : 79701-6800
Country : US
Telephone Number : 432-683-2723
Fax Number : 432-683-4907
Provider Business Practice Location Address
First Line : 2405 W MISSOURI AVE
Second Line :
City : MIDLAND
State : TX
Zip : 79701-6800
Country : US
Telephone Number : 432-683-2723
Fax Number : 432-683-4907
Authorized Official
Title or Position : PRESIDENT
Name : MICHAEL S MILLER
Credential : M.D.
Telephone Number : 432-683-2723
Provider Enumeration Date : 02/21/2007
Last Update Date : 08/22/2020

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Directions to “PERMIAN CARDIOLOGY ASSOCIATES ” Practice Location

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