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Organization
PHYSICIANS CARDIOVASCULAR DIAGNOSTIC CENTER, L.L.P.
Active
Organization
PHYSICIANS CARDIOVASCULAR DIAGNOSTIC CENTER, L.L.P.
Active
Other names
CARDIOVASCULAR DIAGNOSTIC CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS RANDOLPH LOMBARDO M.D. (MANAGING PARTNER)
(409) 924-3996
Entity
Organization
Contact information
Practice address
2955 HARRISON ST, STE 300, BEAUMONT, TX 77702-1157
(409) 924-3996
(409) 924-3916
Mailing address
2955 HARRISON ST, STE 300, BEAUMONT, TX 77702-1157
(409) 924-3996
(409) 924-3916
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
R25618
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155417201
—
TX
01
—
470001866
MEDICARE RAILROAD PROVIDE
TX
01
—
HH1821
BLUECROSS BLUESHIELD PROV
TX
Enumeration date
05/31/2005
Last updated
01/27/2009
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