Provider Demographics
NPI:1033251988
Name:HOUSTON INTERVENTIONAL CARDIOLOGY PA
Entity Type:Organization
Organization Name:HOUSTON INTERVENTIONAL CARDIOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BAUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-912-6777
Mailing Address - Street 1:21212 NORTHWEST FREEWAY SUITE 535
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429
Mailing Address - Country:US
Mailing Address - Phone:832-912-6777
Mailing Address - Fax:832-912-6888
Practice Address - Street 1:21212 NORTHWEST FREEWAY SUITE 535
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429
Practice Address - Country:US
Practice Address - Phone:832-912-6777
Practice Address - Fax:832-912-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147565901Medicaid
TX00656RMedicare ID - Type Unspecified