Heart Health Clinic PLLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

K5967 Issued in TX

Legal business name

HEART HEALTH CLINIC PLLC

Practice address

808 Woodrow Wilson Ray Cir
Bridgeport, TX 76426-2061

Phone

(469) 908-0400

Fax

(469) 908-0401

NPI assigned

Oct 13, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bruce Michael Gordon, DO

Title

Owner

Phone

(469) 908-0040

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16777/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1144731464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 RAMBLING WAY",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750937601",
            "telephone_number": "469-908-0400",
            "fax_number": "469-908-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 WOODROW WILSON RAY CIR",
            "city": "BRIDGEPORT",
            "state": "TX",
            "postal_code": "764262061",
            "telephone_number": "469-908-0400",
            "fax_number": "469-908-0401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4682 McDermott Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750247772",
            "country_code": "US",
            "telephone_number": "469-908-0400",
            "fax_number": "469-908-0401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEART HEALTH CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-13",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-908-0040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "K5967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "K5967",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Erwin, DC
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• Stephen Lee Hanson, DPT
• Christopher Aaron Hicks, P.T.
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• Jacob Mayberry Assisting Services

• Cardiovascular Disease Physician in Bridgeport, TX
• Providers in Bridgeport, TX by specialty
• Cardiovascular Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.