Provider Demographics
NPI:1285647966
Name:VICTORIA CARDIOVASCULAR IMAGING LP
Entity Type:Organization
Organization Name:VICTORIA CARDIOVASCULAR IMAGING LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HARISH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-788-6628
Mailing Address - Street 1:601 E SAN ANTONIO ST STE 104W
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-6040
Mailing Address - Country:US
Mailing Address - Phone:361-788-6628
Mailing Address - Fax:361-788-6932
Practice Address - Street 1:601 E SAN ANTONIO ST STE 104W
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-6040
Practice Address - Country:US
Practice Address - Phone:361-788-6627
Practice Address - Fax:361-580-2201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X267Medicare PIN