Organization Active NPI

Cardiovascular Clinic of Texas

  • Specialist
  • Houston, TX
National Provider Identifier
1225288673
Registry record updated Mar 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
F2730 Issued in TX
Legal business name
CARDIOVASCULAR CLINIC OF TEXAS
Practice address
8520 Knight Rd
Houston, TX 77054-3808
Phone
(713) 790-1335
Fax
(713) 790-1044
NPI assigned
Sep 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2009

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

Authorized official

Name
Matteethra Chandy Jacob, M.D.NPI 1417020744
Title
President
Phone
(713) 790-1335

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X F2730 TX Primary

Addresses

Primary practice location

8520 Knight Rd
Houston, TX 77054-3808

Mailing address

4006 Inverness Dr
Houston, TX 77019-1006
Phone (713) 790-1335

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090224000330 TX Part B Supplier - Clinic/Group Practice 7911968029 Receives reassigned benefits from 2 practitioners
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

5990 Airline Dr
Ste 260
Houston, TX 77076
Phone (713) 691-7355

8520 Knight Rd
Houston, TX 77054
Phone (713) 790-1335

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BHFECD

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237766400000",
    "number": "1225288673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4006 INVERNESS DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770191006",
            "telephone_number": "713-790-1335",
            "fax_number": "713-790-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8520 KNIGHT RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770543808",
            "telephone_number": "713-790-1335",
            "fax_number": "713-790-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR CLINIC OF TEXAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2009-03-23",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "MATTEETHRA",
        "authorized_official_middle_name": "CHANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-790-1335",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "F2730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; 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.