Provider Demographics
NPI:1205243052
Name:TEXAS CARDIOLOGY & WELLNESS CTR PLLC
Entity type:Organization
Organization Name:TEXAS CARDIOLOGY & WELLNESS CTR PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ORREGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-439-9494
Mailing Address - Street 1:PO BOX 37337
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85069-7337
Mailing Address - Country:US
Mailing Address - Phone:623-439-9494
Mailing Address - Fax:888-723-6867
Practice Address - Street 1:926 E MCDOWELL RD STE 203
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2508
Practice Address - Country:US
Practice Address - Phone:623-439-9494
Practice Address - Fax:623-439-9495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ486352Medicaid
AZ071498Medicaid