Provider Demographics
NPI:1780863480
Name:ELLAHI HEART CLINIC, P.A., TEXAS CORP
Entity Type:Organization
Organization Name:ELLAHI HEART CLINIC, P.A., TEXAS CORP
Other - Org Name:ATIF SOHAIL, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ATIF
Authorized Official - Middle Name:
Authorized Official - Last Name:SOHAIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACC
Authorized Official - Phone:817-419-7220
Mailing Address - Street 1:400 W ARBROOK BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-3176
Mailing Address - Country:US
Mailing Address - Phone:817-419-7220
Mailing Address - Fax:817-419-7222
Practice Address - Street 1:400 W ARBROOK BLVD STE 220
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-3176
Practice Address - Country:US
Practice Address - Phone:817-419-7220
Practice Address - Fax:817-419-7222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7782178174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0066KZOtherBLUE CROSS/BLUE SHIELD
TX167445901Medicaid
TX00W425Medicare PIN