NPIMap

Organization Active NPI

Capital Cardiothoracic Surgeons PA

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Austin, TX
National Provider Identifier
1720010184
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
CAPITAL CARDIOTHORACIC SURGEONS PA
Practice address
2217 Park Bend Dr Ste 220
Austin, TX 78758-5674
Phone
(512) 494-9985
Fax
(512) 494-9986
NPI assigned
Jul 7, 2006
Last updated
Nov 19, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Authorized official

Name
Ms. Sandra Ezell
Title
Administrator
Phone
(512) 494-9985

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU Primary

Addresses

Primary practice location

2217 Park Bend Dr Ste 220
Austin, TX 78758-5674

Mailing address

2217 Park Bend Dr Ste 220
Austin, TX 78758-5674
Phone (512) 494-9985

Other identifiers 1

IdentifierTypeStateIssuer
141590301MedicaidTX

National Provider Directory

National Provider Directory

Locations

1015 E 32nd St
Ste 404
Austin, TX 78705
Phone (512) 494-9985

6500 N Mopac Expy
Ste 2207
Austin, TX 78731
Phone (512) 494-9985

Practitioners & affiliated clinicians

Practitioners 7

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": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605744000000",
    "number": "1720010184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 PARK BEND DR STE 220",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585674",
            "telephone_number": "512-494-9985",
            "fax_number": "512-494-9986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 PARK BEND DR STE 220",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585674",
            "telephone_number": "512-494-9985",
            "fax_number": "512-494-9986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL CARDIOTHORACIC SURGEONS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A",
        "authorized_official_last_name": "EZELL",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "512-494-9985",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141590301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.