Provider Demographics
NPI:1689986465
Name:SOUTH HAMPTON MULTI-SPECIALTY CLINIC
Entity Type:Organization
Organization Name:SOUTH HAMPTON MULTI-SPECIALTY CLINIC
Other - Org Name:COMPREHENSIVE CARDIAC AND VASCULAR INTERVENTIONAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-623-4400
Mailing Address - Street 1:2929 S HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75224-3026
Mailing Address - Country:US
Mailing Address - Phone:214-623-4400
Mailing Address - Fax:214-623-4871
Practice Address - Street 1:221 W COLORADO BLVD STE 730
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2357
Practice Address - Country:US
Practice Address - Phone:214-946-9898
Practice Address - Fax:214-946-7445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty