Organization
FEDERICO MAESE MD PA
Active
Other names
Ferris Heart Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FEDERICO MAESE MD (PRESIDENT)
(469) 719-3690
Entity
Organization
Contact information
Practice address
269 E OVILLA RD STE 100, RED OAK, TX 75154-2616
(469) 719-3690
(469) 719-3680
Mailing address
269 E OVILLA RD STE 100, RED OAK, TX 75154-2616
(469) 719-3690
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
J4319
TX
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
293D00000X
Physiological Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131230801
—
TX
01
—
J4319
LICENSE TX
TX
01
—
TXB145190
MEDICARE PTAN
TX
Enumeration date
12/30/2011
Last updated
02/07/2023
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