Provider Demographics
NPI:1093869190
Name:CARDIOVASCULAR SPECILAISTS, INC.
Entity Type:Organization
Organization Name:CARDIOVASCULAR SPECILAISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROLSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-455-0842
Mailing Address - Street 1:4224 HOUMA BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2933
Mailing Address - Country:US
Mailing Address - Phone:504-455-0842
Mailing Address - Fax:
Practice Address - Street 1:4224 HOUMA BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2933
Practice Address - Country:US
Practice Address - Phone:504-455-0842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1348015Medicaid
LA1309869Medicaid
LA1315141Medicaid
LA1398241Medicaid
LA1191205Medicaid
LA1387681Medicaid
LA1387681Medicaid
LA1398241Medicaid
LAB65356Medicare UPIN
LAB26990Medicare UPIN
LA1348015Medicaid
LAE41790Medicare UPIN
LAB62731Medicare UPIN
LAE54554Medicare UPIN
LA1309869Medicaid