NACOGDOCHES HEART CLINIC PA NPI 1609895861

NPI Information

NPI: 1609895861
Provider Name: NACOGDOCHES HEART CLINIC, PA
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 45D0052220

Address:
1303 N MOUND ST
NACOGDOCHES, TX
ZIP 75961
Phone: (936) 560-1844
Get Directions

NACOGDOCHES HEART CLINIC, PA is a primary care clinic center in Nacogdoches, TX. NACOGDOCHES HEART CLINIC, PA NPI is 1609895861. The provider is registered as an organization entity type.

The provider's business location address is:

1303 N MOUND ST
NACOGDOCHES, TX
ZIP 75961-030
Phone: (936) 560-1844
Fax: (936) 715-9135

The provider's authorized official is Prabahakar R Guniganti .
The authorized official title is Owner and has the following contact phone number (936) 560-1844.

The CLIA number assigned to this NPI record is 45D0052220 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/19/2006 and was last updated on 2/12/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CI2485	MEDICARE ID-TYPE UNSPECIFIED	TEXAS	RAILROAD MEDICARE #
2	00D17C	MEDICARE PIN	TEXAS
3	00D17C	OTHER	TEXAS	BLUE CROSS PROVIDER #
4	082003702	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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