Provider Demographics
NPI:1225194129
Name:METROPOLITAN CARDIOLOGY P A
Entity Type:Organization
Organization Name:METROPOLITAN CARDIOLOGY P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIMA
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:NWAUKWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-935-4003
Mailing Address - Street 1:PO BOX 12600
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77726-2600
Mailing Address - Country:US
Mailing Address - Phone:409-832-6200
Mailing Address - Fax:409-832-6216
Practice Address - Street 1:740 HOSPITAL DR STE 200
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4663
Practice Address - Country:US
Practice Address - Phone:409-832-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4901207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190912901Medicaid