Organization
CAPITAL CARDIOTHORACIC SURGEONS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA EZELL (ADMINISTRATOR)
(512) 494-9985
Entity
Organization
Contact information
Practice address
2217 PARK BEND DR STE 220, AUSTIN, TX 78758-5674
(512) 494-9985
(512) 494-9986
Mailing address
2217 PARK BEND DR STE 220, AUSTIN, TX 78758-5674
(512) 494-9985
(512) 494-9986
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141590301
—
TX
Enumeration date
07/07/2006
Last updated
11/19/2020
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