Provider Demographics
NPI:1649400490
Name:HEART AND VASCULAR PLLC
Entity Type:Organization
Organization Name:HEART AND VASCULAR PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HIMACHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:VELIGANDLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-679-0581
Mailing Address - Street 1:118 TRADEPARK DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-3427
Mailing Address - Country:US
Mailing Address - Phone:606-679-0581
Mailing Address - Fax:606-679-1261
Practice Address - Street 1:118 TRADEPARK DR
Practice Address - Street 2:SUITE B
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-3427
Practice Address - Country:US
Practice Address - Phone:606-679-0581
Practice Address - Fax:606-679-1261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40110207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty