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Organization

HOUSTON CARDIAC ASSOCIATION, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BAXTER DELWORTH MONTGOMERY M.D. (PHYSICIAN/EXECUTIVE DIRECTOR)
(713) 599-1144
Entity
Organization

Contact information

Practice address
10480 MAIN ST, HOUSTON, TX 77025-5500
(713) 599-1144
(713) 599-1199
Mailing address
10480 MAIN ST, HOUSTON, TX 77025-5500
(713) 599-1144
(713) 599-1199

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
H9549
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
081027701
TX
01
10018324
AMERIGROUP
TX
05
132190301
TX
01
5034595
AETNA
TX
01
85680F
BCBS OF TEXAS
TX
Enumeration date
05/08/2007
Last updated
03/16/2012
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