Provider Demographics
NPI:1801818935
Name:ADVANCED CARDIAC CARE ASSOCIATION
Entity Type:Organization
Organization Name:ADVANCED CARDIAC CARE ASSOCIATION
Other - Org Name:AKIRA NISHIKAWA
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-795-0115
Mailing Address - Street 1:6400 FANNIN ST
Mailing Address - Street 2:SUITE 2210A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1521
Mailing Address - Country:US
Mailing Address - Phone:713-795-0115
Mailing Address - Fax:832-582-3595
Practice Address - Street 1:6400 FANNIN ST
Practice Address - Street 2:SUITE 2210A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1521
Practice Address - Country:US
Practice Address - Phone:713-795-0115
Practice Address - Fax:832-582-3595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7295174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID
TX=========OtherTAX ID