Provider Demographics
NPI:1750701496
Name:KINGSVILLE CARDIOVASCULAR CLINIC, PA
Entity type:Organization
Organization Name:KINGSVILLE CARDIOVASCULAR CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-993-5606
Mailing Address - Street 1:1311 GENERAL CAVAZOS BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78363-7150
Mailing Address - Country:US
Mailing Address - Phone:361-993-5606
Mailing Address - Fax:
Practice Address - Street 1:1311 GENERAL CAVAZOS BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-7150
Practice Address - Country:US
Practice Address - Phone:361-993-5606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX347607Medicare PIN