Provider Demographics
NPI:1235356171
Name:PLANO HEART CENTER, P.A.
Entity Type:Organization
Organization Name:PLANO HEART CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:POONAM
Authorized Official - Middle Name:GOYAL
Authorized Official - Last Name:AGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-596-9200
Mailing Address - Street 1:4104 W 15TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5860
Mailing Address - Country:US
Mailing Address - Phone:972-596-9200
Mailing Address - Fax:972-596-9206
Practice Address - Street 1:4104 W 15TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5860
Practice Address - Country:US
Practice Address - Phone:972-596-9200
Practice Address - Fax:972-596-9206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9006207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G58408Medicare UPIN
00554VMedicare ID - Type Unspecified