Nacogdoches Heart Clinic, PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

NACOGDOCHES HEART CLINIC, PA

Practice address

1303 N Mound St
Nacogdoches, TX 75961-4030

Phone

(936) 560-1844

Fax

(936) 715-9135

NPI assigned

Jul 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Prabahakar R Guniganti, M.D.

Title

Owner

Phone

(936) 560-1844

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423699200000",
    "number": "1609895861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 N MOUND ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614030",
            "telephone_number": "936-560-1844",
            "fax_number": "936-715-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 N MOUND ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614030",
            "telephone_number": "936-560-1844",
            "fax_number": "936-715-9135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NACOGDOCHES HEART CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2015-02-12",
        "status": "A",
        "authorized_official_last_name": "GUNIGANTI",
        "authorized_official_first_name": "PRABAHAKAR",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-560-1844",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "082003702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "00D17C",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nacogdoches Nephrology, PA

• Primary Care Clinic/Center in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.