Provider Demographics
NPI:1902266208
Name:NORTH TEXAS COMPREHENSIVE CARDIOLOGY, PLLC
Entity Type:Organization
Organization Name:NORTH TEXAS COMPREHENSIVE CARDIOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ULMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-821-6177
Mailing Address - Street 1:425 N HIGHLAND AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7377
Mailing Address - Country:US
Mailing Address - Phone:903-361-7869
Mailing Address - Fax:903-598-7726
Practice Address - Street 1:425 N HIGHLAND AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7377
Practice Address - Country:US
Practice Address - Phone:903-361-7869
Practice Address - Fax:903-598-7726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00248QMedicare PIN
TXC15074Medicare UPIN
TX00524NMedicare PIN