Provider Demographics
NPI:1609366608
Name:HORIZON CARDIOVASCULAR DIAGNOSTIC IMAGING CENTER
Entity type:Organization
Organization Name:HORIZON CARDIOVASCULAR DIAGNOSTIC IMAGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-893-5339
Mailing Address - Street 1:9888 BELLAIRE BLVD STE 154
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3430
Mailing Address - Country:US
Mailing Address - Phone:713-893-5339
Mailing Address - Fax:
Practice Address - Street 1:9888 BELLAIRE BLVD STE 154
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3430
Practice Address - Country:US
Practice Address - Phone:713-893-5339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JF SOUTHWEST HEART CLINIC PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty