Provider Demographics
NPI:1871868497
Name:ANDRES MESA MD PA
Entity Type:Organization
Organization Name:ANDRES MESA MD PA
Other - Org Name:CARDIOVASCULAR & VEIN INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:MESA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-834-6678
Mailing Address - Street 1:888 NORMANDY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-4940
Mailing Address - Country:US
Mailing Address - Phone:832-834-6678
Mailing Address - Fax:832-834-6672
Practice Address - Street 1:888 NORMANDY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-4940
Practice Address - Country:US
Practice Address - Phone:832-834-6678
Practice Address - Fax:832-834-6672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-14
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4957207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH06671Medicare UPIN