NPIMap

Organization Active NPI

Cardiovascular Associates of East Texas PA

  • Cardiovascular Disease Physician
  • Tyler, TX
National Provider Identifier
1447212303
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CARDIOVASCULAR ASSOCIATES OF EAST TEXAS PA
Practice address
1783 Troup Hwy
Tyler, TX 75701-5869
Phone
(903) 595-2283
Fax
(903) 595-1063
NPI assigned
Apr 5, 2006
Last updated
Oct 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Mrs. Debbie Kirkpatrick
Title
Support Supervisor
Phone
(903) 595-2283

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X NU
Interventional Cardiology Physician 207RI0011X NU

Addresses

Primary practice location

1783 Troup Hwy
Tyler, TX 75701-5869

Mailing address

1783 Troup Hwy
Tyler, TX 75701-5869
Phone (903) 595-2283

Other identifiers 3

IdentifierTypeStateIssuer
00G58POtherTXBCBS
CS6546OtherTXRR MEDICARE
109339501MedicaidTX

National Provider Directory

National Provider Directory

Locations

105 N High St
Henderson, TX 75652
Phone (903) 392-8259

2001 W Ferguson Rd
Mt Pleasant, TX 75455
Phone (903) 606-7525

3201 S Loop 256
Ste 500
Palestine, TX 75801
Phone (903) 661-7057

115 W 5th St
Tyler, TX 75701

Practitioners & affiliated clinicians

Practitioners 7

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": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1447212303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1783 TROUP HWY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015869",
            "telephone_number": "903-595-2283",
            "fax_number": "903-595-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1783 TROUP HWY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015869",
            "telephone_number": "903-595-2283",
            "fax_number": "903-595-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR ASSOCIATES OF EAST TEXAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "KIRKPATRICK",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "SUPPORT SUPERVISOR",
        "authorized_official_telephone_number": "903-595-2283",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00G58P",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CS6546",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109339501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.