Organization
HEART CENTER OF NORTH TEXAS, PA
Active
Other names
Heart Center of North Texas
Organization subpart
No
Provider details
NPI number
Authorized official
SYDNEY MADDEN (ADMINISTRATOR)
(817) 334-2800
Entity
Organization
Contact information
Practice address
1017 12TH AVE, FORT WORTH, TX 76104-3915
(817) 334-2800
(817) 820-0094
Mailing address
1017 12TH AVE, FORT WORTH, TX 76104-3915
(817) 334-2800
(817) 820-0094
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00455K
BLUE CROSS BLUE SHIELD
TX
05
—
109377504
—
TX
01
—
5930155
AETNA GROUP
TX
Enumeration date
07/16/2006
Last updated
06/22/2021
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