Organization
HEART CENTER OF NORTH TEXAS, PA
Active
Parent organization
HEART CENTER OF NORTH TEXAS
Other names
Heart Center of North Texas
Organization subpart
Yes
Provider details
NPI number
Legal business name
HEART CENTER OF NORTH TEXAS
Authorized official
SYDNEY MADDEN (ADMINISTRATOR)
(817) 334-2800
Entity
Organization
Contact information
Practice address
1200 CRAWFORD AVE STE A, GRANBURY, TX 76048-4560
(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
BCBS GROUP NUMBER
TX
05
—
109377503
—
TX
01
—
5930155
AETNA GROUP NUMBER
TX
Enumeration date
05/22/2007
Last updated
06/22/2021
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