NPIMap

Organization Active NPI

Cardiovascular Association, PLLC

  • Cardiovascular Disease Physician
  • Dayton, TX
National Provider Identifier
1033442173
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CARDIOVASCULAR ASSOCIATION, PLLC
Practice address
601 S Winfree St
Dayton, TX 77535-2945
Phone
(713) 796-9696
NPI assigned
Sep 8, 2009
Last updated
Aug 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mazen Ganim, MDNPI 1740398577
Title
Partner
Phone
(713) 796-9696

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

601 S Winfree St
Dayton, TX 77535-2945

Mailing address

601 S Winfree St
Dayton, TX 77535-2945
Phone (713) 796-9696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317000182 TX Part B Supplier - Clinic/Group Practice 5294625042 Receives reassigned benefits from 56 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Livingston, TX; Sugar Land, TX; Pearland, TX; Liberty, TX; Kingwood, TX; Humble, TX; Houston, TX; Beaumont, TX…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312934400000",
    "number": "1033442173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S WINFREE ST",
            "city": "DAYTON",
            "state": "TX",
            "postal_code": "775352945",
            "telephone_number": "713-796-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S WINFREE ST",
            "city": "DAYTON",
            "state": "TX",
            "postal_code": "775352945",
            "telephone_number": "713-796-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR ASSOCIATION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-08",
        "last_updated": "2011-08-10",
        "status": "A",
        "authorized_official_last_name": "GANIM",
        "authorized_official_first_name": "MAZEN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "713-796-9696",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.