Provider Demographics
NPI:1457906000
Name:CARDINAL FIVE GROUP
Entity Type:Organization
Organization Name:CARDINAL FIVE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EVANS
Authorized Official - Middle Name:
Authorized Official - Last Name:TACHIE-MENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-633-5292
Mailing Address - Street 1:1708 SPRING GREEN BLVD STE 120-343
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7462
Mailing Address - Country:US
Mailing Address - Phone:832-633-5292
Mailing Address - Fax:
Practice Address - Street 1:1732 W SAM HOUSTON PKWY N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-2723
Practice Address - Country:US
Practice Address - Phone:888-300-2412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-09
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty