Provider Demographics
NPI:1114220365
Name:STRONG HEART CARDIOVASCULAR PA
Entity Type:Organization
Organization Name:STRONG HEART CARDIOVASCULAR PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:W
Authorized Official - Last Name:SWAIN
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:361-857-0005
Mailing Address - Street 1:601 TEXAN TRL
Mailing Address - Street 2:301
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-2547
Mailing Address - Country:US
Mailing Address - Phone:361-857-0005
Mailing Address - Fax:
Practice Address - Street 1:601 TEXAN TRL
Practice Address - Street 2:301
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-2547
Practice Address - Country:US
Practice Address - Phone:361-857-0005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218826001Medicaid
TX218826001Medicaid