Provider Demographics
NPI:1043829955
Name:CARDIACFITT, LLC
Entity Type:Organization
Organization Name:CARDIACFITT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:SHONTAL
Authorized Official - Last Name:DOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-238-2825
Mailing Address - Street 1:PO BOX 131224
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75313-1224
Mailing Address - Country:US
Mailing Address - Phone:214-238-2825
Mailing Address - Fax:
Practice Address - Street 1:2201 MAIN ST STE 400-9
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-4327
Practice Address - Country:US
Practice Address - Phone:214-238-2825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LECKI HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty