Provider Demographics
NPI:1598186223
Name:MEDICAL PLAZA CARDIOLOGY
Entity Type:Organization
Organization Name:MEDICAL PLAZA CARDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OF EMP PHY SER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:RENAE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-577-6555
Mailing Address - Street 1:2015 MULBERRY AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-2312
Mailing Address - Country:US
Mailing Address - Phone:903-577-7070
Mailing Address - Fax:
Practice Address - Street 1:2015 MULBERRY AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-2312
Practice Address - Country:US
Practice Address - Phone:903-577-7070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TITUS REGIONAL MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-24
Last Update Date:2013-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty