Provider Demographics
NPI:1134750995
Name:SPECIALIZED HEART CARE, PLLC.
Entity type:Organization
Organization Name:SPECIALIZED HEART CARE, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTHCARE BUSINESS CONSULTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUMENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-623-4469
Mailing Address - Street 1:1431 HIDDEN OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:TX
Mailing Address - Zip Code:76210-2826
Mailing Address - Country:US
Mailing Address - Phone:224-623-4469
Mailing Address - Fax:844-387-6314
Practice Address - Street 1:6750 N MACARTHUR BLVD STE 205
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2470
Practice Address - Country:US
Practice Address - Phone:469-963-0656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1992723241OtherNPI