Provider Demographics
NPI:1710982301
Name:CARDIOPULMONARY THERAPEUTICS AND DIAGNOSTICS INC
Entity Type:Organization
Organization Name:CARDIOPULMONARY THERAPEUTICS AND DIAGNOSTICS INC
Other - Org Name:MED EQUIP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:RECKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-772-6970
Mailing Address - Street 1:PO BOX 8160
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76714-8160
Mailing Address - Country:US
Mailing Address - Phone:254-772-6970
Mailing Address - Fax:866-725-4443
Practice Address - Street 1:7400 IMPERIAL DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-6605
Practice Address - Country:US
Practice Address - Phone:254-772-6970
Practice Address - Fax:866-725-4443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173274501Medicaid
TX173274502Medicaid
60054OtherAETNA
TX173274501Medicaid
104644100OtherFIRSTCARE