Provider Demographics
NPI:1568495984
Name:NORTH TEXAS CARDIOLOGY LLP
Entity Type:Organization
Organization Name:NORTH TEXAS CARDIOLOGY LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IBRAHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-893-6579
Mailing Address - Street 1:3515 N LOY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2506
Mailing Address - Country:US
Mailing Address - Phone:903-893-6579
Mailing Address - Fax:903-893-7293
Practice Address - Street 1:3515 N LOY LAKE RD
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2506
Practice Address - Country:US
Practice Address - Phone:903-893-6579
Practice Address - Fax:903-893-7293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00845UMedicare UPIN