Provider Demographics
NPI:1629264734
Name:PEDIATRIC CARDIOLOGY ASSO. P.C.
Entity Type:Organization
Organization Name:PEDIATRIC CARDIOLOGY ASSO. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ISRAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-536-1081
Mailing Address - Street 1:303 WILLIAMS AVE SW
Mailing Address - Street 2:SUITE 1121
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6012
Mailing Address - Country:US
Mailing Address - Phone:256-536-1081
Mailing Address - Fax:256-536-1082
Practice Address - Street 1:303 WILLIAMS AVE SW
Practice Address - Street 2:SUITE 1121
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6012
Practice Address - Country:US
Practice Address - Phone:256-536-1081
Practice Address - Fax:256-536-1082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL124002080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty