Provider Demographics
NPI:1225217375
Name:NORTHWEST CARDIOLOGY CONSULTANTS PA
Entity Type:Organization
Organization Name:NORTHWEST CARDIOLOGY CONSULTANTS PA
Other - Org Name:DBA NORTHWEST CARDIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ATTIYA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-955-0786
Mailing Address - Street 1:21212 NORTHWEST FWY
Mailing Address - Street 2:SUITE 555
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5884
Mailing Address - Country:US
Mailing Address - Phone:281-955-0786
Mailing Address - Fax:281-955-8848
Practice Address - Street 1:21212 NORTHWEST FWY
Practice Address - Street 2:SUITE 555
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5884
Practice Address - Country:US
Practice Address - Phone:281-955-0786
Practice Address - Fax:281-955-8848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8196207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00A26JMedicare PIN