Provider Demographics
NPI:1114255031
Name:SOUTHEAST TEXAS CARDIOVASCULAR PA
Entity Type:Organization
Organization Name:SOUTHEAST TEXAS CARDIOVASCULAR PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEVINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-397-7000
Mailing Address - Street 1:PO BOX 4356
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4356
Mailing Address - Country:US
Mailing Address - Phone:281-397-7000
Mailing Address - Fax:281-397-7016
Practice Address - Street 1:8901 FM 1960 BYPASS RD W
Practice Address - Street 2:SUITE 303
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4018
Practice Address - Country:US
Practice Address - Phone:281-397-7000
Practice Address - Fax:281-397-7016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty