Organization
CARDIOVASCULAR ASSOCIATES OF EAST TEXAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBBIE KIRKPATRICK (SUPPORT SUPERVISOR)
(903) 595-2283
Entity
Organization
Contact information
Practice address
1783 TROUP HWY, TYLER, TX 75701-5869
(903) 595-2283
(903) 595-1063
Mailing address
1783 TROUP HWY, TYLER, TX 75701-5869
(903) 595-2283
(903) 595-1063
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
—
00G58P
BCBS
TX
05
—
109339501
—
TX
01
—
CS6546
RR MEDICARE
TX
Enumeration date
04/05/2006
Last updated
10/20/2022
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