Provider Demographics
NPI:1437357357
Name:CARDIOVASCULAR INSTITUTE PA
Entity Type:Organization
Organization Name:CARDIOVASCULAR INSTITUTE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DALJIT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:MUTTIANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-357-5700
Mailing Address - Street 1:355 SCHOOL STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375
Mailing Address - Country:US
Mailing Address - Phone:281-357-5700
Mailing Address - Fax:281-357-8822
Practice Address - Street 1:355 SCHOOL STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375
Practice Address - Country:US
Practice Address - Phone:281-357-5700
Practice Address - Fax:281-357-8822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5507022OtherAETNA
TX0020MWOtherBCBS OF TEXAS
TX133664601Medicaid
TX133664601Medicaid