Provider Demographics
NPI:1922144583
Name:CARDIOVASCULAR ON CALL SPECIALISTS INC
Entity Type:Organization
Organization Name:CARDIOVASCULAR ON CALL SPECIALISTS INC
Other - Org Name:CVS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MORTON
Authorized Official - Middle Name:JEFFERSON
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:III
Authorized Official - Credentials:RCIS RDCS RVT
Authorized Official - Phone:214-363-6611
Mailing Address - Street 1:PO BOX 863722
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75086-3722
Mailing Address - Country:US
Mailing Address - Phone:214-363-6611
Mailing Address - Fax:214-363-6851
Practice Address - Street 1:808 STONE TRAIL DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-7108
Practice Address - Country:US
Practice Address - Phone:214-363-6611
Practice Address - Fax:214-363-6851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0092KYOtherBCBS
TX088010601Medicaid
TX0092KYOtherBCBS