Provider Demographics
NPI:1669443826
Name:CARDIOLOGY ASSOCIATES OF CORPUS CHRISTI
Entity Type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF CORPUS CHRISTI
Other - Org Name:CARDIOLOGY ASSOCIATES OF CORPUS CHRISTI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:VASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-885-6543
Mailing Address - Street 1:1521 S STAPLES ST STE 700
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-3160
Mailing Address - Country:US
Mailing Address - Phone:361-888-8271
Mailing Address - Fax:361-885-3699
Practice Address - Street 1:1521 S STAPLES ST
Practice Address - Street 2:SUITE 700
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3150
Practice Address - Country:US
Practice Address - Phone:361-888-8271
Practice Address - Fax:361-885-3699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-27
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081795901Medicaid
TX081795901Medicaid