Fort Worth Cardiovascular Center, L.P.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

L04659 Issued in TX

Legal business name

FORT WORTH CARDIOVASCULAR CENTER, L.P.

Practice address

1650 W Rosedale St
Suite 206
Fort Worth, TX 76104-7400

Phone

(817) 877-0052

Fax

(817) 877-4103

NPI assigned

May 19, 2006

Last updated

Aug 31, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey M Flanegin III

Title

President

Phone

(610) 831-1112

Specialties & licenses 1

Addresses

Tax ID family

Fort Worth Cardiovascular Center LP2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fort Worth Cardiovascular Center, LP

  • Medical Specialty Clinic/Center
  • Windsor, CT
  • NPI 1114122603
  NPD tax ID

Locations

Practitioners 1

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.

• Luis A Campos, M.D. FACC

  • Interventional Cardiology Physician
  • Houston, TX
  • NPI 1952424962
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188518400000",
    "number": "1639123219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WATERSIDE XING",
            "address_2": "3RD FLOOR ATTN: KAREN FRISK, CONTRACTING",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951540",
            "telephone_number": "800-367-1095",
            "fax_number": "860-298-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 W ROSEDALE ST",
            "address_2": "SUITE 206",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047400",
            "telephone_number": "817-877-0052",
            "fax_number": "817-877-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WORTH CARDIOVASCULAR CENTER, L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-08-31",
        "status": "A",
        "authorized_official_last_name": "FLANEGIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-831-1112",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TX",
            "license": "L04659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Medical Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; 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.