Provider Demographics
NPI:1437621232
Name:CARDIACUS DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:CARDIACUS DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-331-5540
Mailing Address - Street 1:4411 BLUEBONNET DR STE 104
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-2912
Mailing Address - Country:US
Mailing Address - Phone:281-900-9750
Mailing Address - Fax:
Practice Address - Street 1:14833 SOUTHWEST FWY STE B202
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5016
Practice Address - Country:US
Practice Address - Phone:713-331-5540
Practice Address - Fax:713-331-5540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty