Provider Demographics
NPI:1023204567
Name:CARDIAC INTERVENTION SPECIALISTS, P.A.
Entity Type:Organization
Organization Name:CARDIAC INTERVENTION SPECIALISTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LADONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-230-5065
Mailing Address - Street 1:2222 GREENHOUSE RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-7252
Mailing Address - Country:US
Mailing Address - Phone:832-230-5065
Mailing Address - Fax:281-579-1709
Practice Address - Street 1:2222 GREENHOUSE RD
Practice Address - Street 2:SUITE 600
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7252
Practice Address - Country:US
Practice Address - Phone:281-646-9911
Practice Address - Fax:281-579-1709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6497207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0037GWOtherBCBS
TX00758ROtherRAILROAD MEDICARE
TX147419901Medicaid
TX00758RMedicare PIN