Provider Demographics
NPI:1407841984
Name:TEXARKANA CARDIOVASCULAR & THORACIC SURGICAL ASSOCIATES PA
Entity Type:Organization
Organization Name:TEXARKANA CARDIOVASCULAR & THORACIC SURGICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-614-5600
Mailing Address - Street 1:2604 SAINT MICHAEL DR
Mailing Address - Street 2:SUITE 425
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2379
Mailing Address - Country:US
Mailing Address - Phone:903-614-5600
Mailing Address - Fax:903-614-5630
Practice Address - Street 1:2604 SAINT MICHAEL DR
Practice Address - Street 2:SUITE 425
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2379
Practice Address - Country:US
Practice Address - Phone:903-614-5600
Practice Address - Fax:903-614-5630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-12
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00066RMedicare ID - Type Unspecified