| Dfw Cardiovascular Institute Pllc | |
|
9901 Valley Ranch Pkwy E Ste 101 Irving TX 75063-4730 | |
| (985) 713-1173 | |
| Not Available |
| Full Name | Dfw Cardiovascular Institute Pllc |
|---|---|
| Speciality | Surgery |
| Location | 9901 Valley Ranch Pkwy E Ste 101, Irving, Texas |
| Authorized Official Name and Position | Jason Mareno (OWNER) |
| Authorized Official Contact | 9724171936 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dfw Cardiovascular Institute Pllc 9901 Valley Ranch Pkwy E Ste 101 Irving TX 75063-4730 Ph: (985) 713-1173 | Dfw Cardiovascular Institute Pllc 9901 Valley Ranch Pkwy E Ste 101 Irving TX 75063-4730 Ph: (985) 713-1173 |
| NPI Number | 1043955404 |
|---|---|
| Provider Enumeration Date | 04/30/2022 |
| Last Update Date | 01/05/2023 |
| Medicare PECOS PAC ID | 7315325016 |
|---|---|
| Medicare Enrollment ID | O20220608003296 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043955404 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 2086S0129X | Surgery - Vascular Surgery | (* (Not Available)) | Primary |
| Provider Name | Henry C Dees |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659371375 PECOS PAC ID: 1254320930 Enrollment ID: I20040507001233 |
| Provider Name | Jerome G Naifeh |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1003893728 PECOS PAC ID: 8921062167 Enrollment ID: I20041228000061 |
| Provider Name | Peter P Chang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780688028 PECOS PAC ID: 4789775008 Enrollment ID: I20070801000132 |
| Provider Name | Michelle Ann Newton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083710685 PECOS PAC ID: 2668555772 Enrollment ID: I20080213000308 |
| Provider Name | Fely Ong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710403894 PECOS PAC ID: 9931465184 Enrollment ID: I20171104000103 |
| Provider Name | Alesia Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710451224 PECOS PAC ID: 0345627279 Enrollment ID: I20220516002001 |
| Provider Name | Stergios Zissis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083211726 PECOS PAC ID: 3274945266 Enrollment ID: I20221004000125 |
| Provider Name | Magdalene O Obaroghedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417404526 PECOS PAC ID: 1052608361 Enrollment ID: I20221102001624 |
| Provider Name | Andreana Sara Min |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114799434 PECOS PAC ID: 1355783366 Enrollment ID: I20240522002195 |
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