Provider Demographics
NPI:1568649465
Name:CARDIO PULMONARY THPC AND DIAGNOSTICS INC.
Entity Type:Organization
Organization Name:CARDIO PULMONARY THPC AND DIAGNOSTICS INC.
Other - Org Name:MED-EQUIP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:STRAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-772-6970
Mailing Address - Street 1:PO BOX 8160
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76714-8160
Mailing Address - Country:US
Mailing Address - Phone:254-772-6970
Mailing Address - Fax:254-772-5652
Practice Address - Street 1:6950 COLLEGE DR.
Practice Address - Street 2:SUITE A
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-3201
Practice Address - Country:US
Practice Address - Phone:409-861-4130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARDIO PULMONARY THPC AND DIAGNOSTICS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-23
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0034713332B00000X, 332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0563220004Medicare NSC