Provider Demographics
NPI:1134175797
Name:HEARTSCAN OF PASADENA, LP
Entity type:Organization
Organization Name:HEARTSCAN OF PASADENA, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-943-8668
Mailing Address - Street 1:3315 BURKE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1827
Mailing Address - Country:US
Mailing Address - Phone:713-943-8668
Mailing Address - Fax:713-943-8339
Practice Address - Street 1:3315 BURKE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1827
Practice Address - Country:US
Practice Address - Phone:713-943-8668
Practice Address - Fax:713-943-8339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTN031Medicare ID - Type UnspecifiedPROVIDER NUMBER