Organization
EP-CARDIOLOGY PA
Active
Parent organization
EP/CARDIOLOGY PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
EP/CARDIOLOGY PA
Authorized official
MS. JO ANN NEVITT (PRACTICE MANAGER)
(713) 799-1610
Entity
Organization
Contact information
Practice address
500 MEDICAL CENTER BLVD, SUITE 310, CONROE, TX 77304-2889
(936) 441-3232
(936) 756-3235
Mailing address
6550 FANNIN ST, SUITE 1723, HOUSTON, TX 77030-2717
(713) 799-1610
(713) 799-1558
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00438R
BLUE SHIELD
TX
01
—
CH7910
MEDICARE RR
—
Enumeration date
12/07/2007
Last updated
09/11/2008
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