Provider Demographics
NPI:1437213105
Name:HEART AND VASCULAR OF CENTRAL TEXAS PA
Entity Type:Organization
Organization Name:HEART AND VASCULAR OF CENTRAL TEXAS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-206-2999
Mailing Address - Street 1:16010 PARK VALLEY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-3574
Mailing Address - Country:US
Mailing Address - Phone:512-206-2999
Mailing Address - Fax:
Practice Address - Street 1:16010 PARK VALLEY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-3574
Practice Address - Country:US
Practice Address - Phone:512-206-2999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2357207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty