# MID-CITIES CARDIAC CARE CENTER, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326458191
- **Authorized official:** DR. RUSSELL FISHER (PRESIDENT)
- **Authorized official phone:** (817) 510-1060

## Contact information

- **Practice address:** 1305 AIRPORT FWY, SUITE 421, BEDFORD, TX 76021-6605
- **Practice address phone:** (817) 510-1060
- **Mailing address:** 1305 AIRPORT FWY, SUITE 421, BEDFORD, TX 76021-6605

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | L06641 | TX | Yes |

## Other

- **Enumeration date:** 05/02/2014
- **Last updated:** 05/02/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | L06641 | RADIOACTIVE MATERIAL LICENSE | — |