Provider Demographics
NPI:1104164755
Name:TEXAS HEART HOSPITAL OF THE SOUTHWEST LLP
Entity type:Organization
Organization Name:TEXAS HEART HOSPITAL OF THE SOUTHWEST LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:Z
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-814-3506
Mailing Address - Street 1:1100 ALLIED DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5348
Mailing Address - Country:US
Mailing Address - Phone:469-814-3278
Mailing Address - Fax:469-814-4361
Practice Address - Street 1:1100 ALLIED DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5348
Practice Address - Country:US
Practice Address - Phone:469-814-3278
Practice Address - Fax:469-814-4361
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS HEART HOSPITAL OF THE SOUTHWEST LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-16
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGroup - Multi-Specialty