Organization
STATE OF THE HEART CARDIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ANDREW OSBORNE MD (DIRECTOR)
(817) 808-2488
Entity
Organization
Contact information
Practice address
1920 E STATE HIGHWAY 114, SOUTHLAKE, TX 76092
(817) 442-5698
(817) 442-5633
Mailing address
712 WINDING RIDGE TRAIL, SOUTHLAKE, TX 76092
(817) 808-2488
(844) 466-8137
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
03/25/2019
Last updated
03/25/2019
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