DR. IMAM EKO TJAHJA (NPI# 1760472948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760472948 |
| Entity Type | Individual |
| Full Name | DR. IMAM EKO TJAHJA |
| Credential | MD |
| Practice Address |
12340 Bandera Rd Ste 104 Helotes TX 78023 |
| Mailing Address |
12340 Bandera Rd Ste 104 Helotes TX 78023-4575 |
| Practice Telephone | 2109208000 |
| Practice Fax Number | 2109206000 |
| Mailing Telephone | 2109208000 |
| Mailing Fax Number | 2109206000 |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2020-04-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
J9393 | TX | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
J9393 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICARE ID | 629794AS1D | 01 |
| TX | 104420801 | 05 |
| Street Address |
12340 BANDERA RD STE 104 |
| City | HELOTES |
| State | TX |
| Zip Code | 78023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386150985 | Cardiovascular Institute of South Texas, Pllc | Internal Medicine | 12340 Bandera Rd Ste 104, Helotes, TX 78023 | 2017-12-18 |
| 1619262755 | Mehdi Rambod | Internal Medicine | 12340 Bandera Rd Ste 104, Helotes, TX 78023-4575 | 2011-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750743696 | Natalya Bejar | Dentist | 12415 Bandera, 110, Helotes, TX 78023 | 2016-03-21 |
| 1235317470 | Jeffrey Mays Hart | Optometrist | 21325 Private Road 177, Helotes, TX 78023 | 2008-02-08 |
| 1528260544 | Candace Clare Lochridge | Physical Therapy Assistant | 11018 Chicory Field, Helotes, TX 78023 | 2007-06-01 |
| 1538299383 | Jose Antonio Brigman | Dentist | 12415 Bandera Rd., Suite 110, Helotes, TX 78023 | 2007-03-07 |
| 1720148778 | Marlena L. Pomelow | Dentist | 14938 San Pasqual, Helotes, TX 78023 | 2006-12-11 |
| 1790855716 | Mohamed Farouk Mitwally | Obstetrics & Gynecology | 122 Candelaria, Helotes, TX 78023 | 2006-11-08 |
| 1992811889 | Thomas J Haberman Dds PC | Dentist | 13438 Bandera Rd, #202, Helotes, TX 78023 | 2006-08-22 |
| 1871521823 | Karen T. Allsup | Obstetrics & Gynecology | 12850 Bandera Rd Ste 106, Helotes, TX 78023 | 2006-06-29 |
| 1396726725 | Thp Inc | Durable Medical Equipment & Medical Supplies | 12914 Bandera Hwy, Helotes, TX 78023 | 2005-11-11 |
| 1063987626 | River City Oral and Maxillofacial Surgery, Pllc | Clinic/Center | 5418 N Loop 1604 E, Suite 101, San Antonio, TX 78023 | 2018-10-10 |
| Find all providers in zip 78023 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164913190 | Bruce T. Kuo, Md, Pa | Internal Medicine | 12340 Bandera Rd Ste 105, Helotes, TX 78023-4575 | 2018-05-24 |
| 1619114295 | Tzy-shiuan Bruce Kuo | Internal Medicine | 12340 Bandera Rd Ste 2104, Helotes, TX 78023-4574 | 2009-01-19 |
| 1386150985 | Cardiovascular Institute of South Texas, Pllc | Internal Medicine | 12340 Bandera Rd Ste 104, Helotes, TX 78023 | 2017-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205433455 | Chalkias Cardiology Pllc | Internal Medicine | 11671 Jollyville Rd Ste 120, Austin, TX 78759-4141 | 2020-10-01 |
| 1992318992 | Us Televero Health Pa | Internal Medicine | 1204 Rockcliff Rd, Austin, TX 78746-1604 | 2020-08-28 |
| 1245856087 | Texas Heart Medical Group | Internal Medicine | 6770 Bertner Avenue, Houston, TX 77030-2604 | 2020-06-17 |
| 1043831753 | Shawn Sommerlad Pllc | Internal Medicine | 322 Robin Way, Richardson, TX 75080-2522 | 2020-05-04 |
| 1295354611 | Cardiocentric | Internal Medicine | 1401 Seminole Dr, Richardson, TX 75080-3738 | 2020-04-15 |
| 1134750995 | Specialized Heart Care, Pllc. | Internal Medicine | 7200 N Highway 161 Ste 205, Irving, TX 75039-4132 | 2020-01-30 |
| 1114578978 | Amir Azeem, Md, Pa | Internal Medicine | 5306 Clouds Creek Ln, Sugar Land, TX 77479-4940 | 2019-09-24 |
| 1831740802 | Premier Heart Center, Pllc | Internal Medicine | 10440 N Central Expy Ste 1400, Dallas, TX 75231-2235 | 2019-09-21 |
| 1124677042 | Kirk M Lipscomb | Internal Medicine | 2902 Canyon Creek Dr, Richardson, TX 75080-1503 | 2019-09-04 |
| 1790333516 | C Care Cardiovascular Center | Internal Medicine | 1445 Bessemer Dr Ste E, El Paso, TX 79936-5909 | 2019-08-27 |
| Find all providers with the same taxonomy | ||||
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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.