Organization
CARDIAC CATH LAB OF IDAHO FALLS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC FOURNET (CHIEF FINANCIAL OFFICER)
(713) 574-1015
Entity
Organization
Contact information
Practice address
3311 VALENCIA DRIVE, IDAHO FALLS, ID 83404
(415) 218-9820
Mailing address
2200 POST OAK BLVD STE 1525, HOUSTON, TX 77056-4711
(713) 574-1015
(832) 271-1037
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RI0011X
Interventional Cardiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Enumeration date
09/05/2018
Last updated
09/05/2018
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