Provider Demographics
NPI:1558565705
Name:PREMIER CARDIOVASCULAR CONSULTANTS PC
Entity Type:Organization
Organization Name:PREMIER CARDIOVASCULAR CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NABIL
Authorized Official - Middle Name:MAHMOOD
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-593-2899
Mailing Address - Street 1:1105 N WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-3732
Mailing Address - Country:US
Mailing Address - Phone:281-593-3389
Mailing Address - Fax:281-592-0479
Practice Address - Street 1:901 E HOUSTON ST
Practice Address - Street 2:SUITE C
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-4602
Practice Address - Country:US
Practice Address - Phone:281-593-3389
Practice Address - Fax:281-592-0479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0739207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX194264101Medicaid
TX00Z274Medicare PIN