MEDICARE: CARDIOLOGY CARE CONSULTANTS, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	207R00000X	Internal Medicine Physician
2	207RI0011X	Interventional Cardiology Physician
3	207UN0901X	Nuclear Cardiology Physician
4	2085B0100X	Body Imaging Physician	TX
5	2085R0202X	Diagnostic Radiology Physician
6	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	Q2471	OTHER	TX	RR MCR GRP #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	00K58Q	OTHER	TX	BX/BS TEXAS

General Provider Information

NPI Number	:	1821076167
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOLOGY CARE CONSULTANTS, PA

Provider Business Mailing Address
First Line	:	7814 GATEWAY BLVD E
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79915-1815
Country	:	US
Telephone Number	:	915-542-2352
Fax Number	:	915-593-8559

Provider Business Practice Location Address
First Line	:	4301 N MESA ST
Second Line	:	STE 101
City	:	EL PASO
State	:	TX
Zip	:	79902-1118
Country	:	US
Telephone Number	:	915-542-2352
Fax Number	:	915-313-6692

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPH A QUINTANA
Credential	:	M.D.
Telephone Number	:	915-542-2352

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	11/30/2011

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Directions to “CARDIOLOGY CARE CONSULTANTS, PA ” Practice Location

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