Organization
ELITE HEART, LUNG, AND VEIN SURGEONS
Active
Other names
Elite Heart, Lung, and Vein Surgeons
Organization subpart
No
Provider details
NPI number
Authorized official
LACEY BUFORD (PRACTICE ADMINISTRATOR)
(936) 648-6975
Entity
Organization
Contact information
Practice address
920 MEDICAL PLAZA DR STE 360, SHENANDOAH, TX 77380-3271
(281) 803-8482
(281) 803-8432
Mailing address
920 MEDICAL PLAZA DR STE 360, SHENANDOAH, TX 77380-3271
(281) 803-8482
(281) 803-8432
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
L1655
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145174210
—
TX
Enumeration date
12/11/2017
Last updated
04/23/2021
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