Organization Active NPI

Wichita Falls Cardiac Care PA

  • Cardiovascular Disease Physician
  • Wichita Falls, TX
National Provider Identifier
1629288543
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
WICHITA FALLS CARDIAC CARE PA
Practice address
1518 10TH St
Wichita Falls, TX 76301-4405
Phone
(940) 723-6400
Fax
(940) 723-6403
NPI assigned
May 22, 2007
Last updated
Oct 2, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Authorized official

Name
Venkateswarlu Thota, M.D.
Title
Owner Member
Phone
(940) 723-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

1518 10TH St
Wichita Falls, TX 76301-4405

Mailing address

1518 10TH St
Wichita Falls, TX 76301-4405
Phone (940) 723-6400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070822000407 TX Part B Supplier - Clinic/Group Practice 7517059660 Receives reassigned benefits from 1 practitioner
Practice locations: Electra, TX; Olney, TX; Vernon, TX; Wichita Falls, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1629288543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 10TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014405",
            "telephone_number": "940-723-6400",
            "fax_number": "940-723-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 10TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014405",
            "telephone_number": "940-723-6400",
            "fax_number": "940-723-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA FALLS CARDIAC CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "THOTA",
        "authorized_official_first_name": "VENKATESWARLU",
        "authorized_official_title_or_position": "OWNER MEMBER",
        "authorized_official_telephone_number": "940-723-6400",
        "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 Oct 2, 2007; 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.