Provider Demographics
NPI:1518327303
Name:XAVIER HEART INSTITUTE PLLC
Entity Type:Organization
Organization Name:XAVIER HEART INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNDON
Authorized Official - Middle Name:C
Authorized Official - Last Name:XAVIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-908-3634
Mailing Address - Street 1:PO BOX 7810
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-7810
Mailing Address - Country:US
Mailing Address - Phone:480-275-7944
Mailing Address - Fax:480-275-8805
Practice Address - Street 1:655 S DOBSON RD
Practice Address - Street 2:STE. A108
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5667
Practice Address - Country:US
Practice Address - Phone:480-275-7944
Practice Address - Fax:480-275-8805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28442207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZH83892Medicare UPIN