NPIMap

Organization Active NPI

Wichita Falls Heart Clinic PLLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Wichita Falls, TX
National Provider Identifier
1215486691
Registry record updated Jun 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
WICHITA FALLS HEART CLINIC PLLC
Practice address
2101 9TH St
Wichita Falls, TX 76301-4133
Phone
(940) 766-3190
Fax
(940) 687-1617
NPI assigned
Sep 27, 2016
Last updated
Jun 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2017

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

Authorized official

Name
Andre DesireNPI 1568427714
Title
Chairman
Phone
(940) 687-5000

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
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU Primary

Addresses

Primary practice location

2101 9TH St
Wichita Falls, TX 76301-4133

Mailing address

2101 9TH St
Wichita Falls, TX 76301-4133
Phone (940) 766-3190

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161122001146 TX Part B Supplier - Clinic/Group Practice 4688953219 Receives reassigned benefits from 5 practitioners
Practice locations: Wichita Falls, TX

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14449/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497225600000",
    "number": "1215486691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 9TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014133",
            "telephone_number": "940-766-3190",
            "fax_number": "940-687-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 9TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014133",
            "telephone_number": "940-766-3190",
            "fax_number": "940-687-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA FALLS HEART CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-27",
        "last_updated": "2017-06-12",
        "status": "A",
        "authorized_official_last_name": "DESIRE",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "940-687-5000"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; 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.