Provider Demographics
NPI:1497810345
Name:GOOD SHEPHERD HEART CARE PLLC
Entity Type:Organization
Organization Name:GOOD SHEPHERD HEART CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BABUJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-682-6500
Mailing Address - Street 1:4725 GUS THOMASSON RD
Mailing Address - Street 2:SUITE 8,
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-1734
Mailing Address - Country:US
Mailing Address - Phone:972-682-6500
Mailing Address - Fax:972-682-6501
Practice Address - Street 1:1050 N BELT LINE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-1782
Practice Address - Country:US
Practice Address - Phone:972-682-6500
Practice Address - Fax:972-682-6501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5039207R00000X, 261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH60787Medicare UPIN
TX00X668Medicare PIN