Provider Demographics
NPI:1710018767
Name:CARDIOVASCULAR SUPPORT SERVICES, INC.
Entity Type:Organization
Organization Name:CARDIOVASCULAR SUPPORT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:YANCEY
Authorized Official - Suffix:
Authorized Official - Credentials:LP, CCP
Authorized Official - Phone:214-824-2510
Mailing Address - Street 1:3409 WORTH ST.
Mailing Address - Street 2:#725
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2029
Mailing Address - Country:US
Mailing Address - Phone:214-824-2510
Mailing Address - Fax:214-826-0130
Practice Address - Street 1:3409 WORTH ST
Practice Address - Street 2:#725
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2029
Practice Address - Country:US
Practice Address - Phone:214-824-2510
Practice Address - Fax:214-826-0130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPF0081246X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularGroup - Multi-Specialty