Provider Demographics
NPI:1821672122
Name:CVC MEDICAL PA
Entity Type:Organization
Organization Name:CVC MEDICAL PA
Other - Org Name:HIGHLANDS MEDICAL AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-338-5574
Mailing Address - Street 1:1000 E BELT LINE RD STE 112
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-6282
Mailing Address - Country:US
Mailing Address - Phone:972-338-5574
Mailing Address - Fax:
Practice Address - Street 1:1000 E BELT LINE RD # 112
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-6282
Practice Address - Country:US
Practice Address - Phone:972-338-5574
Practice Address - Fax:469-393-7206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1770927634OtherCHRISTINA CASEY - INDIVIDUAL NPI
TX351641102Medicaid