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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