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	207RC0000X	Cardiovascular Disease Physician	H3275	TX

General Provider Information

NPI Number	:	1780977132
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	:	M.D.
Telephone Number	:	281-988-6462

Provider Enumeration Date	:	05/18/2011
Last Update Date	:	03/28/2013

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