NPIMap

Organization Active NPI

Wichita Heart and Vascular Center, PLLC

  • Cardiovascular Disease Physician
  • Wichita Falls, TX
National Provider Identifier
1306016225
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
WICHITA HEART AND VASCULAR CENTER, PLLC
Practice address
1631 11TH St
Suite a
Wichita Falls, TX 76301-4320
Phone
(940) 264-3222
Fax
(940) 264-3225
NPI assigned
Mar 6, 2008
Last updated
Sep 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Authorized official

Name
Dr. Bruce L Palmer, M.D.NPI 1750474078
Title
Owner/Member
Phone
(940) 264-3222

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

1631 11TH St
Suite a
Wichita Falls, TX 76301-4320

Mailing address

1631 11TH St
Suite a
Wichita Falls, TX 76301-4320
Phone (940) 264-3222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080616000484 TX Part B Supplier - Clinic/Group Practice 6204907405 Receives reassigned benefits from 2 practitioners
Practice locations: Wichita Falls, TX

National Provider Directory

National Provider Directory

Locations

1100 Brook Ave
Wichita Falls, TX 76301
Phone (940) 322-4480

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": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348704000000",
    "number": "1306016225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 11TH ST",
            "address_2": "SUITE A",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014320",
            "telephone_number": "940-264-3222",
            "fax_number": "940-264-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 11TH ST",
            "address_2": "SUITE A",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014320",
            "telephone_number": "940-264-3222",
            "fax_number": "940-264-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA HEART AND VASCULAR CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2012-09-27",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "940-264-3222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "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 Sep 27, 2012; 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.