Provider Demographics
NPI:1508139791
Name:VICTORIA HEART AND VASCULAR CENTER, P.A.
Entity Type:Organization
Organization Name:VICTORIA HEART AND VASCULAR CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARISH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-580-2200
Mailing Address - Street 1:2104 PATTERSON DR
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5639
Mailing Address - Country:US
Mailing Address - Phone:361-580-2200
Mailing Address - Fax:361-580-2201
Practice Address - Street 1:2104 PATTERSON DR
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5639
Practice Address - Country:US
Practice Address - Phone:361-580-2200
Practice Address - Fax:361-580-2201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-17
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX298815601Medicaid
0076XKOtherBCBS ID