Provider Demographics
NPI:1306036058
Name:CARDIAC CENTER OF TEXAS
Entity Type:Organization
Organization Name:CARDIAC CENTER OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:AKRAM
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-529-6939
Mailing Address - Street 1:PO BOX 951450
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75395-1450
Mailing Address - Country:US
Mailing Address - Phone:972-529-6939
Mailing Address - Fax:972-529-6935
Practice Address - Street 1:3931 JOE RAMSEY BLVD E STE D
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-7777
Practice Address - Country:US
Practice Address - Phone:972-529-6939
Practice Address - Fax:972-529-6935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4878174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0059JVOtherBLUE CROSS BLUE SHIELD
TXDB4251OtherRAIL ROAD MEDICARE
TX00647UMedicare PIN