Provider Demographics
NPI:1114097565
Name:CARDIOLOGY SPECIALISTS OF HOUSTON
Entity Type:Organization
Organization Name:CARDIOLOGY SPECIALISTS OF HOUSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:TREISTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-797-1620
Mailing Address - Street 1:6624 FANNIN ST
Mailing Address - Street 2:SUITE 1420
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2312
Mailing Address - Country:US
Mailing Address - Phone:713-797-1620
Mailing Address - Fax:713-797-1543
Practice Address - Street 1:6624 FANNIN ST
Practice Address - Street 2:SUITE 1420
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2312
Practice Address - Country:US
Practice Address - Phone:713-797-1620
Practice Address - Fax:713-797-1543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMDD8915207RC0000X
TXMDF3420207RC0000X
TXMDK4957207RC0000X
TXL7868207RC0000X
TXMDJ2112207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX084755001Medicaid
TXCG2179OtherRAILROAD MEDICARE
TXCG2179OtherRAILROAD MEDICARE