Provider Demographics
NPI:1003205873
Name:HEART AND RHYTHM INSTITUTE OF SOUTH TEXAS, PA
Entity Type:Organization
Organization Name:HEART AND RHYTHM INSTITUTE OF SOUTH TEXAS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WASSIM
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHOUCAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-779-3094
Mailing Address - Street 1:PO BOX 1436
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78295-1436
Mailing Address - Country:US
Mailing Address - Phone:210-998-6900
Mailing Address - Fax:210-998-6907
Practice Address - Street 1:8122 DATAPOINT DR STE 120
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3264
Practice Address - Country:US
Practice Address - Phone:210-998-6900
Practice Address - Fax:210-998-6907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-16
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4299207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX364883401Medicaid