Provider Demographics
NPI:1780977132
Name:BELLAIRE CARDIOVASCULAR CARE, PA
Entity type:Organization
Organization Name:BELLAIRE CARDIOVASCULAR CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LOI
Authorized Official - Middle Name:PHI
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-988-6462
Mailing Address - Street 1:12112 BELLAIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-2315
Mailing Address - Country:US
Mailing Address - Phone:281-988-6462
Mailing Address - Fax:281-988-7462
Practice Address - Street 1:12112 BELLAIRE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2315
Practice Address - Country:US
Practice Address - Phone:281-988-6462
Practice Address - Fax:281-988-7462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3275207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty