Provider Demographics
NPI:1275507865
Name:CARDIOLOGY CONSULTANTS OF TEXAS
Entity Type:Organization
Organization Name:CARDIOLOGY CONSULTANTS OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAMBLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-826-5000
Mailing Address - Street 1:PO BOX 660080
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0080
Mailing Address - Country:US
Mailing Address - Phone:214-824-5600
Mailing Address - Fax:
Practice Address - Street 1:621 N HALL ST
Practice Address - Street 2:SUITE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1339
Practice Address - Country:US
Practice Address - Phone:214-824-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9632207RC0000X
TXD0393207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145164302Medicaid
TX145164301Medicaid
TX145164301Medicaid
TX145164302Medicaid