Provider Demographics
NPI:1710589122
Name:TEXAS HEART AND VASCULAR CARE PLLC
Entity Type:Organization
Organization Name:TEXAS HEART AND VASCULAR CARE PLLC
Other - Org Name:TEXAS HEART AND VASCULAR CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AFSHEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-214-4405
Mailing Address - Street 1:987 N WALNUT CREEK DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8016
Mailing Address - Country:US
Mailing Address - Phone:817-455-5755
Mailing Address - Fax:
Practice Address - Street 1:987 N WALNUT CREEK DR STE 101
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-8016
Practice Address - Country:US
Practice Address - Phone:682-214-4405
Practice Address - Fax:682-214-3404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1689649303Medicaid