Provider Demographics
NPI:1851427942
Name:CARDIAC ASSOCIATES OF DALLAS
Entity Type:Organization
Organization Name:CARDIAC ASSOCIATES OF DALLAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISTAIR
Authorized Official - Middle Name:IAN
Authorized Official - Last Name:FYFE
Authorized Official - Suffix:II
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:972-566-8474
Mailing Address - Street 1:7777 FOREST LN STE C655
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-6867
Mailing Address - Country:US
Mailing Address - Phone:972-566-8474
Mailing Address - Fax:972-566-8475
Practice Address - Street 1:7777 FOREST LN STE C655
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-6867
Practice Address - Country:US
Practice Address - Phone:972-566-8474
Practice Address - Fax:972-566-8475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8750174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDB4213OtherMEDICARE RR
TXDB4213OtherMEDICARE RR