East Texas Heart & Vascular Imaging LTD

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EAST TEXAS HEART & VASCULAR IMAGING LTD

Practice address

310 Gaslight Blvd
Lufkin, TX 75904-3133

Phone

(936) 632-8787

Fax

(936) 632-8832

NPI assigned

Aug 28, 2006

Organization subpart

No

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

Authorized official

Name

Ravinder R Bachireddy, M.D

Title

President

Phone

(936) 632-8787

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218672000000",
    "number": "1407964539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 GASLIGHT BLVD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043133",
            "telephone_number": "936-632-8787",
            "fax_number": "936-632-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 GASLIGHT BLVD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043133",
            "telephone_number": "936-632-8787",
            "fax_number": "936-632-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS HEART & VASCULAR IMAGING LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2008-08-14",
        "status": "A",
        "authorized_official_last_name": "BACHIREDDY",
        "authorized_official_first_name": "RAVINDER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-632-8787",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048374502",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF TEXAS",
            "identifier": "HH1819",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Texas Chest Clinic, P.a.
• East Texas Eye Associates
• East Texas Eye Associates
• East Texas Eye Associates
• East Texas Foot Associates
• East Texas Heart & Vascular Imaging of Lufkin, PA
• East Texas Hematology & Oncology
• East Texas Hematology & Oncology
• East Texas Id Associates PLLC
• East Texas Internal Medicine PA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; 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.