Provider Demographics
NPI:1073550208
Name:EAST TEXAS CARDIOLOGY P.A.
Entity Type:Organization
Organization Name:EAST TEXAS CARDIOLOGY P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANWAR
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-651-1787
Mailing Address - Street 1:PO BOX 36728
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77236-6728
Mailing Address - Country:US
Mailing Address - Phone:713-651-1787
Mailing Address - Fax:713-651-1791
Practice Address - Street 1:2000 CRAWFORD ST
Practice Address - Street 2:1403
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-9000
Practice Address - Country:US
Practice Address - Phone:713-651-1787
Practice Address - Fax:713-651-1791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182758601Medicaid
DF0398OtherRAIL ROAD MEDICARE
0070NTOtherBCBS
G50169Medicare UPIN