Organization
CARDIOLOGY CONSULTANTS OF EAST TEXAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILAN SEKULIC M.D. (PRESIDENT)
(903) 577-7070
Entity
Organization
Contact information
Practice address
2015 MULBERRY AVE, SUITE 310, MT PLEASANT, TX 75455-2312
(903) 577-7070
(903) 577-7072
Mailing address
2015 MULBERRY AVE, SUITE 310, MT PLEASANT, TX 75455-2312
(903) 577-7070
(903) 577-7072
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
M2087
TX
363A00000X
Physician Assistant
PA04780
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104879915
INDIVIDUAL NPI FOR PA
TX
01
—
1265464564
INDIVIDUAL NPI
TX
05
—
1766404-01
—
TX
01
—
TXB157920
MEDICARE PTAN FOR PA
TX
Enumeration date
05/18/2007
Last updated
12/16/2013
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