Provider Demographics
NPI:1366464273
Name:CYFAIR CARDIOLOGY ASSOC PA
Entity Type:Organization
Organization Name:CYFAIR CARDIOLOGY ASSOC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-808-7381
Mailing Address - Street 1:11111 JONES RD STE 1
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-6317
Mailing Address - Country:US
Mailing Address - Phone:281-890-4886
Mailing Address - Fax:281-894-2247
Practice Address - Street 1:11111 JONES RD STE 1
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-6317
Practice Address - Country:US
Practice Address - Phone:281-808-7381
Practice Address - Fax:281-894-2247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX036183401Medicaid
TX036183401Medicaid