East Texas Cardiovascular Labs, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

008031 Issued in TX

Legal business name

EAST TEXAS CARDIOVASCULAR LABS, LLC

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. Prabhakar R Guniganti, M.D.

Title

Owner

Phone

(936) 560-1844

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1689693830",
    "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": "EAST TEXAS CARDIOVASCULAR LABS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "GUNIGANTI",
        "authorized_official_first_name": "PRABHAKAR",
        "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": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "TX",
            "license": "008031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "HH1807",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034329502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debeia Duffield-Holmes
• David L Duke III, MD
• Hannah Dunahoe
• Shahzada Durrani
• East Texas Cardiovascular Labs LLC (Nacogdoches Surgical Center LTD)
• East Texas Center for Metabolic Wellness LLC
• East Texas Community Health Services, Inc
• East Texas Community Health Services, Inc.
• East Texas Medical Specialties
• East Texas Physicians Care PA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; 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.