Organization
CARDIOVASCULAR CONSULTANTS OF NORTH TEXAS, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRENT L PETTIJOHN MD (MANAGING PARTNER)
(469) 800-4400
Entity
Organization
Contact information
Practice address
6300 W PARKER RD, SUITE 125, PLANO, TX 75093-8100
(469) 800-4400
(469) 800-4410
Mailing address
1600 W COLLEGE ST, SUITE 680, GRAPEVINE, TX 76051-3581
(817) 912-8400
(817) 912-8410
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147632702
—
TX
Enumeration date
04/26/2007
Last updated
09/28/2012
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