Provider Demographics
NPI:1568472595
Name:CARDIOLOGY INSTITUTE, INC
Entity Type:Organization
Organization Name:CARDIOLOGY INSTITUTE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:YASSER
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHLED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-649-1152
Mailing Address - Street 1:1051 GAUSE BLVD
Mailing Address - Street 2:320
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2951
Mailing Address - Country:US
Mailing Address - Phone:985-641-7577
Mailing Address - Fax:985-643-0826
Practice Address - Street 1:1051 GAUSE BLVD
Practice Address - Street 2:320
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2951
Practice Address - Country:US
Practice Address - Phone:985-641-7577
Practice Address - Fax:985-643-0826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09013682Medicaid
LA1942073Medicaid
MS09013682Medicaid