Provider Demographics
NPI:1639314511
Name:HEART AND VASCULAR CLINIC, P.A.
Entity Type:Organization
Organization Name:HEART AND VASCULAR CLINIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FADI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFAYOUMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-698-5613
Mailing Address - Street 1:844 CENTRAL BLVD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7552
Mailing Address - Country:US
Mailing Address - Phone:956-698-5613
Mailing Address - Fax:956-698-4953
Practice Address - Street 1:844 CENTRAL BLVD
Practice Address - Street 2:SUITE 170
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7552
Practice Address - Country:US
Practice Address - Phone:956-698-5613
Practice Address - Fax:956-698-4953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3448207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH93680Medicare UPIN
TX8L3299Medicare PIN