Provider Demographics
NPI:1457517617
Name:SOUTHWEST CARDIOVASCULAR INTERVENTION CLINIC, PA
Entity Type:Organization
Organization Name:SOUTHWEST CARDIOVASCULAR INTERVENTION CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIKEZIE
Authorized Official - Middle Name:CHIDIEBERE
Authorized Official - Last Name:AMADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-373-9066
Mailing Address - Street 1:1508 N ZARAGOZA RD STE ABCD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-8034
Mailing Address - Country:US
Mailing Address - Phone:915-298-5425
Mailing Address - Fax:915-298-5430
Practice Address - Street 1:1508 N ZARAGOZA RD STE ABCD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-8034
Practice Address - Country:US
Practice Address - Phone:915-298-5425
Practice Address - Fax:915-298-5430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9797207RI0011X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty