EAST TEXAS CARDIOVASCULAR LABS, LLC (NPI# 1689693830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689693830 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS CARDIOVASCULAR LABS, LLC |
| Practice Address |
1303 N Mound St Nacogdoches TX 75961-4030 |
| Practice Telephone | 9365601844 |
| Practice Fax Number | 9367159135 |
| Mailing Telephone | 9365601844 |
| Mailing Fax Number | 9367159135 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2013-03-12 |
| Authorized Official Name | MR. PRABHAKAR R GUNIGANTI (OWNER) |
| Authorized Official Telephone | 9365601844 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
008031 | TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS PROVIDER # | HH1807 | 01 |
| TX | 034329502 | 05 |
| Street Address |
1303 N MOUND ST |
| City | NACOGDOCHES |
| State | TX |
| Zip Code | 75961-4030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275961666 | Pioneer Heart Care, P.a. | Clinic/Center | 1303 N Mound St, Nacogdoches, TX 75961-4030 | 2013-10-22 |
| 1679609515 | Drl Labs Ltd | Clinical Medical Laboratory | 1303 N Mound St, Nacogdoches, TX 75961-4030 | 2007-02-26 |
| 1609895861 | Nacogdoches Heart Clinic, Pa | Clinic/Center | 1303 N Mound St, Nacogdoches, TX 75961-4030 | 2006-07-19 |
| 1003835265 | East Texas Cardiovascular Labs LLC | Clinic/Center | 1303 N Mound St, Nacogdoches, TX 75961-4030 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578195582 | Trevon Jerrell Jones | Specialist/Technologist | 13010 Sfa Station, Nacogdoches, TX 75961 | 2020-02-07 |
| 1275014094 | Connie Nicole Hamner | Licensed Vocational Nurse | 214 Cr 387, Nacogdoches, TX 75961 | 2018-08-29 |
| 1689175804 | Barbara Stracener | Registered Nurse | 234 Grove Lane, Nacogdoches, TX 75961 | 2018-02-22 |
| 1710425541 | St.alyssamedical Center | Clinic/Center | 1303 N. Mound Street, Nacogdoches, TX 75961 | 2017-01-31 |
| 1609319458 | Nacogdoches Internal Medicine Pllc | Internal Medicine | 412 North St Ste E, Nacogdoches, TX 75961 | 2016-11-28 |
| 1972982866 | Deanna Ellen Bishop | Nurse Practitioner | 1309 S. University Dr, East Texas Community Health Services, Inc., Nacogdoches, TX 75961 | 2015-05-25 |
| 1659798155 | Dr. Ronnie Hancock Family Dentistry, Pllc | Dental Hygienist | 1302 Raguet Street, Nacogdoches, TX 75961 | 2014-03-21 |
| 1205095585 | Chris R Chambers | Surgery | 1018 N Mound St Ste 106, Nacogdoches, TX 75961 | 2008-06-03 |
| 1972790285 | Assisted Living Concepts Inc | Assisted Living Facility | 901 Oakview Drive, Nacogdoches, TX 75961 | 2007-10-01 |
| 1356492151 | James Knox Dowling | Pediatrics | 2106 N. Raguet, Nacogdoches, TX 75961 | 2007-01-16 |
| Find all providers in zip 75961 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417912544 | Ranek, Lc | Clinic/Center | 4932 North St, Nacogdoches, TX 75965-1878 | 2006-04-20 |
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| 1669093779 | Hi Tech Imaging, LLC | Clinic/Center | 423 Sw Military Dr, San Antonio, TX 78221-1654 | 2020-04-29 |
| 1861027120 | North Star Mcd, LLC | Clinic/Center | 3700 W 15th St Bldg D Ste 200, Plano, TX 75075 | 2020-03-06 |
| 1740814029 | Venus Mri & Women's Center, LLC | Clinic/Center | 24721 Tomball Pkwy Ste 150, Tomball, TX 77375-7727 | 2020-02-26 |
| Find all providers with the same taxonomy | ||||
| City | NACOGDOCHES |
| Zip Code | 75961 |
Please comment or provide details below to improve the information on EAST TEXAS CARDIOVASCULAR LABS, LLC.
| 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.