Depot Bay,Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

DEPOT BAY,INC

Doing business as

Nucardio-Heart-Center

Practice address

805 Hill Blvd
Suite 106
Granbury, TX 76048-1481

Phone

(817) 579-7770

NPI assigned

Jun 4, 2010

Last updated

Jun 4, 2010By 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

Mr. Rami Nader

Title

President

Phone

(724) 971-9717

Specialties & licenses 1

Addresses

Other names 1

• Nucardio-Heart-Center Doing business as

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275609600000",
    "number": "1245550839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5208 BRYANT IRVIN RD",
            "address_2": "SUITE 3143",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 HILL BLVD",
            "address_2": "SUITE 106",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481481",
            "telephone_number": "817-579-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPOT BAY,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-04",
        "last_updated": "2010-06-04",
        "status": "A",
        "authorized_official_last_name": "NADER",
        "authorized_official_first_name": "RAMI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-971-9717",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nucardio-Heart-Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Manuel J Debesa, O.D.
• Nathaniel Delaney
• Delia I. Wright, MD, PA
• Susan M Denevan, LCDC
• Dental Professionals of Texas, P.a. (Granbury Dental Center)
• Haskell Ray Derryberry, FNP
• Avi Deshmukh, M.D.
• Beth Deskin
• Elizabeth Dever
• Marcie Diamond, PTA

• Clinic/Center in Granbury, TX
• Providers in Granbury, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; 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.