Organization
HEART INSTITUTE OF EAST TEXAS P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAVINDER R BACHIREDDY M.D. (PRESIDENT)
(936) 632-8787
Entity
Organization
Contact information
Practice address
310 GASLIGHT BLVD, LUFKIN, TX 75904-3133
(936) 632-8787
(936) 632-8832
Mailing address
310 GASLIGHT BLVD, LUFKIN, TX 75904-3133
(936) 632-8787
(936) 632-8832
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084979601
—
TX
Enumeration date
08/19/2006
Last updated
05/15/2013
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