SOUTHWEST VASCULAR P.C. (NPI# 1093273781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093273781 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST VASCULAR P.C. |
| Practice Address |
4375 Booth Callaway Suite 501 Fort Worth TX 76180 |
| Mailing Address |
2737 South Hulen Street Fort Worth TX 76109 |
| Practice Telephone | 8177700608 |
| Mailing Telephone | 8177700608 |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2019-03-12 |
| Authorized Official Name | MARTHA PROVIDENZA (ADMISTRATOR) |
| Authorized Official Telephone | 8176149552 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
4375 BOOTH CALLAWAY SUITE 501 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063057602 | Heather Penka | Preventive Medicine | 820 Holiday Ln, North Richland Hills, TX 76180 | 2019-11-07 |
| 1871063644 | Christina Luu | Physician Assistant | 4300 City Point Dr Ste 102, North Richland Hills, TX 76180 | 2018-12-04 |
| 1578042917 | Marcos H Guerra | Licensed Vocational Nurse | 4525 City Point Drive, North Richland Hills, TX 76180 | 2018-08-07 |
| 1760975247 | Alliancestar One LLC | Durable Medical Equipment & Medical Supplies | 6719 Mid-cities Blvd, North Richland Hills, TX 76180 | 2018-06-11 |
| 1710486196 | Kayan K Reno | Home Health | 5608 Davis Blvd, North Richland Hills, TX 76180 | 2018-02-12 |
| 1184133209 | Sonja Jackson | Counselor | 2214 Michigan Ave Suite F, Arlington, TX 76180 | 2017-09-20 |
| 1821512880 | Robin Wray Manley | Registered Nurse | 5117 Maryanna Way, North Richland Hills, TX 76180 | 2017-08-01 |
| 1487195442 | D3 Medical | Durable Medical Equipment & Medical Supplies | 5424 Rufe Snow #502, North Richland Hills, TX 76180 | 2017-03-10 |
| 1629510474 | Helping Hands Ministry of Richland Hills | Public Health or Welfare | 7294 Gleview Drive, Richland Hills, TX 76180 | 2016-11-10 |
| 1902275001 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 9200 North Tarrant Parkway, North Richland Hills, TX 76180 | 2015-09-18 |
| Find all providers in zip 76180 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558702373 | Texas Health Care, P.l.l.c. | Surgery | 1307 8th Ave Ste 302, Fort Worth, TX 76104-4140 | 2013-07-09 |
| 1487962916 | Texas Health Care, P.l.l.c. | Surgery | 1250 8th Ave., Suite 240, Fort Worth, TX 76104-4124 | 2010-09-17 |
| 1326061961 | Charles Adger West Jr. | Surgery | 1325 Pennsylvania Ave Ste 680, Fort Worth, TX 76104-2133 | 2006-07-25 |
| 1538186135 | David L Stroman | Surgery | 1250 8th Ave., Suite 240, Fort Worth, TX 76104-4124 | 2006-07-17 |
| 1740825264 | Johnna Jones Do Facos Pa | Surgery | 800 8th Ave Ste 116, Fort Worth, TX 76104-2606 | 2019-11-07 |
| 1376947135 | Vikram Palkar | Surgery | 1500 S Main St, Fort Worth, TX 76104-4917 | 2014-10-22 |
| 1851668925 | Fort Worth Vascular and Surgical Associates, Pa | Surgery | 909 9th Ave, Suite 201, Fort Worth, TX 76104-3903 | 2011-11-17 |
| 1013173764 | Vascular and Vein Center Pa | Surgery | 1325 Pennsylvania Ave, Suite 440, Fort Worth, TX 76104-2128 | 2008-08-01 |
| 1134308091 | North Texas Vein Partners, LLC | Surgery | 2737 S Hulen St, Fort Worth, TX 76109-9535 | 2007-10-29 |
| 1720274533 | Saadi Mohy Aldeen Halbouni | Surgery | 800 8th Ave Ste 306, Fort Worth, TX 76104-2602 | 2007-09-15 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76180 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.