Provider Demographics
NPI:1801900519
Name:CARDIOVASCULAR IMAGING INC
Entity type:Organization
Organization Name:CARDIOVASCULAR IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIAGNOSTIC MEDICAL SONOG
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:LANDRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-898-8007
Mailing Address - Street 1:2955 HARRISON ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1154
Mailing Address - Country:US
Mailing Address - Phone:409-898-8007
Mailing Address - Fax:409-898-8116
Practice Address - Street 1:2955 HARRISON ST
Practice Address - Street 2:SUITE 105
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1154
Practice Address - Country:US
Practice Address - Phone:409-898-8007
Practice Address - Fax:409-898-8116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPL7029OtherTHIN
TXZFTCUV42Medicaid
TXFTCUV4Medicare ID - Type Unspecified