Provider Demographics
NPI:1548423403
Name:CARDIAC AND VASCULAR CENTER, P.C.
Entity Type:Organization
Organization Name:CARDIAC AND VASCULAR CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHMOOD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-279-3500
Mailing Address - Street 1:2704 N GALLOWAY AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-6378
Mailing Address - Country:US
Mailing Address - Phone:972-279-3500
Mailing Address - Fax:972-279-3505
Practice Address - Street 1:2704 N GALLOWAY AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6378
Practice Address - Country:US
Practice Address - Phone:972-279-3500
Practice Address - Fax:972-279-3505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXK4351OtherLICENSE