Provider Demographics
NPI:1740599620
Name:HUMBLE CARDIOVASCULAR SERVICES,PLLC
Entity Type:Organization
Organization Name:HUMBLE CARDIOVASCULAR SERVICES,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARKETING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-768-0703
Mailing Address - Street 1:11510 N LOU AL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2705
Mailing Address - Country:US
Mailing Address - Phone:832-768-0703
Mailing Address - Fax:
Practice Address - Street 1:11510 N LOU AL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2705
Practice Address - Country:US
Practice Address - Phone:832-768-0703
Practice Address - Fax:832-458-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-27
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3253207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty