Provider Demographics
NPI:1538835533
Name:AXIS CARDIOVASCULAR, PLLC
Entity type:Organization
Organization Name:AXIS CARDIOVASCULAR, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FARAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:KURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MSC
Authorized Official - Phone:512-240-5025
Mailing Address - Street 1:4871 WILLIAMS DR
Mailing Address - Street 2:BLDG. 1 SUITE 105
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-2309
Mailing Address - Country:US
Mailing Address - Phone:512-240-5025
Mailing Address - Fax:833-913-2545
Practice Address - Street 1:4871 WILLIAMS DR
Practice Address - Street 2:BLDG. 1 SUITE 105
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78633-2309
Practice Address - Country:US
Practice Address - Phone:407-404-0210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-19
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207RM1200XAllopathic & Osteopathic PhysiciansInternal MedicineMagnetic Resonance Imaging (MRI)Group - Multi-Specialty
No207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant CardiologyGroup - Multi-Specialty
No207RA0002XAllopathic & Osteopathic PhysiciansInternal MedicineAdult Congenital Heart DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty