Provider Demographics
NPI:1891963328
Name:DALLAS CARDIOVASCULAR SURGICAL ASSOCIATION
Entity Type:Organization
Organization Name:DALLAS CARDIOVASCULAR SURGICAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG-TUNG
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:214-361-2300
Mailing Address - Street 1:3608 COLGATE AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6200 W PARKER RD
Practice Address - Street 2:SUITE 103
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7939
Practice Address - Country:US
Practice Address - Phone:214-361-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4907208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty