Provider Demographics
NPI:1538304613
Name:HEART TO HEART CARDIOVASCULAR ASSOCIATES
Entity Type:Organization
Organization Name:HEART TO HEART CARDIOVASCULAR ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUDENSLAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-560-4327
Mailing Address - Street 1:409 RUSSELL BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1248
Mailing Address - Country:US
Mailing Address - Phone:936-560-4327
Mailing Address - Fax:866-927-4221
Practice Address - Street 1:409 RUSSELL BLVD STE A
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1248
Practice Address - Country:US
Practice Address - Phone:936-560-4327
Practice Address - Fax:888-927-4221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2126207RC0000X
207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2628425OtherCIGNA HMO
TX4130361OtherBCBS BLUE LINK
TX145768101Medicaid
TX8R5784OtherBCBS
TX1114931573OtherNPI TYPE 1
TXP00209257OtherRR MEDICARE
TX7859289OtherAETNA
TX4130361OtherBCBS BLUE LINK
TX8D2717Medicare PIN
TX145768101Medicaid