Provider Demographics
NPI:1790809721
Name:DALLAS CARDIAC ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:DALLAS CARDIAC ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:BOEHRER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-688-0228
Mailing Address - Street 1:7777 FOREST LN
Mailing Address - Street 2:SUITE C-860
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2505
Mailing Address - Country:US
Mailing Address - Phone:214-688-0228
Mailing Address - Fax:214-688-1421
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:SUITE C-860
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:214-688-0228
Practice Address - Fax:214-688-1421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167817901Medicaid
TX00560VMedicare ID - Type UnspecifiedGROUP MEDICARE