NPIMap

Organization Active NPI

Corporate Cardiac Consultants LLC

  • Ambulance
  • Southlake, TX
National Provider Identifier
1649429697
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
1000125 Issued in TX
Legal business name
CORPORATE CARDIAC CONSULTANTS LLC
Practice address
1305 Bent Creek Dr
Southlake, TX 76092-9433
Phone
(817) 421-2580
NPI assigned
Sep 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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

Authorized official

Name
Dr. Robert Bruce Genzel, M.D.
Title
Chief Executive Officer
Phone
(817) 421-2580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 1000125 TX Primary

Addresses

Primary practice location

1305 Bent Creek Dr
Southlake, TX 76092-9433

Mailing address

1305 Bent Creek Dr
Southlake, TX 76092-9433
Phone (817) 421-2580

Other names 1

  • Speedway EMS Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1649429697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 BENT CREEK DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929433",
            "telephone_number": "817-421-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 BENT CREEK DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929433",
            "telephone_number": "817-421-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORPORATE CARDIAC CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "GENZEL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "817-421-2580",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TX",
            "license": "1000125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Speedway EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.