Trident Heart and Vascular, PLLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

TRIDENT HEART AND VASCULAR, PLLC

Practice address

5801 Oakbend TRL Ste 250
Fort Worth, TX 76132-3914

Phone

(817) 882-6868

Fax

(817) 439-9115

NPI assigned

Aug 17, 2020

Organization subpart

No

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

Authorized official

Name

Satish Chandraprakasam, MDNPI 1235369695

Title

Ceo and Owner

Phone

(817) 882-6868

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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

• Satish Chandraprakasam, M.D.

  • Interventional Cardiology Physician
  • Fort Worth, TX
  • NPI 1235369695

  Cardiovascular Disease

  Medicare reassignment NPD Authorized official
• Victoria Mree Bainbridge, PA-C

  • Physician Assistant
  • Fort Worth, TX
  • NPI 1659233690
  Medicare reassignment

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1497367015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 OAKBEND TRL STE 270",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 OAKBEND TRL STE 250",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323914",
            "telephone_number": "817-882-6868",
            "fax_number": "817-439-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIDENT HEART AND VASCULAR, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-17",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "CHANDRAPRAKASAM",
        "authorized_official_first_name": "SATISH",
        "authorized_official_title_or_position": "CEO AND OWNER",
        "authorized_official_telephone_number": "817-882-6868",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Dan Tribble, RBT
• David Trice, M.ED, LPC
• Nikita Trice, M. ED., LPC
• Kimberly Michelle Trickett, LCSW
• Trident Anesthesia LLC
• Ha Trieu, OD
• Monty V Trimble, M.D
• Trina Lieske O.D., Fcovd, P.a.
• Trina Lieske OD PA
• Andrea Thao Thanh Trinh

• Cardiovascular Disease Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Cardiovascular Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.