Provider Demographics
NPI:1770839169
Name:ROWLETT CARDIOLOGY ASSOCIATES PA
Entity Type:Organization
Organization Name:ROWLETT CARDIOLOGY ASSOCIATES PA
Other - Org Name:TEXAS CARDIAC ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-475-7500
Mailing Address - Street 1:611 S HIGHWAY 78
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-4081
Mailing Address - Country:US
Mailing Address - Phone:972-475-7500
Mailing Address - Fax:214-427-8650
Practice Address - Street 1:611 S HIGHWAY 78
Practice Address - Street 2:SUITE 102
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-4081
Practice Address - Country:US
Practice Address - Phone:972-475-7500
Practice Address - Fax:214-427-8650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty