Provider Demographics
NPI:1457759771
Name:AFFINITY HEART CARE, PA
Entity Type:Organization
Organization Name:AFFINITY HEART CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-293-2067
Mailing Address - Street 1:215 S DENTON TAP RD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-3229
Mailing Address - Country:US
Mailing Address - Phone:469-293-2067
Mailing Address - Fax:469-293-2083
Practice Address - Street 1:215 S DENTON TAP RD
Practice Address - Street 2:SUITE 225
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-3229
Practice Address - Country:US
Practice Address - Phone:469-293-2067
Practice Address - Fax:469-293-2083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-18
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1626207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147593103Medicaid
TX8687N1Medicare PIN
TXH50233Medicare UPIN