Provider Demographics
NPI:1679503312
Name:CARDIOTHORACIC SURGEONS, PC
Entity Type:Organization
Organization Name:CARDIOTHORACIC SURGEONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:A
Authorized Official - Last Name:VLESSIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PHD
Authorized Official - Phone:541-388-1636
Mailing Address - Street 1:3113 NW CRAFTSMAN DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-8337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2705 NE CONNERS AVE
Practice Address - Street 2:#100
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6904
Practice Address - Country:US
Practice Address - Phone:541-388-1636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty