Provider Demographics
NPI:1881127090
Name:ADVANCED CARDIOVASCULAR SPECIALISTS
Entity type:Organization
Organization Name:ADVANCED CARDIOVASCULAR SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-798-9400
Mailing Address - Street 1:PO BOX 51008
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71135-1008
Mailing Address - Country:US
Mailing Address - Phone:318-798-9400
Mailing Address - Fax:
Practice Address - Street 1:1453 E BERT KOUN LOOP
Practice Address - Street 2:STE 112
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-6800
Practice Address - Country:US
Practice Address - Phone:318-798-9400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-05
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty