Provider Demographics
NPI:1679516736
Name:CARDIOVASCULAR SPECIALTY ASSOCIATES OF NORTH TEXAS, PA
Entity Type:Organization
Organization Name:CARDIOVASCULAR SPECIALTY ASSOCIATES OF NORTH TEXAS, PA
Other - Org Name:CSANT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-550-9195
Mailing Address - Street 1:1320 GREENWAY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-2503
Mailing Address - Country:US
Mailing Address - Phone:972-550-9195
Mailing Address - Fax:972-550-0079
Practice Address - Street 1:1320 GREENWAY DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-2503
Practice Address - Country:US
Practice Address - Phone:972-550-9195
Practice Address - Fax:972-550-0079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133551505Medicaid
TX133551505Medicaid