| Nacogdoches Heart Clinic, Pa | |
|
1303 N Mound St Nacogdoches TX 75961-4030 | |
| (936) 560-1844 | |
| (936) 715-9135 |
| Full Name | Nacogdoches Heart Clinic, Pa |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1303 N Mound St, Nacogdoches, Texas |
| Authorized Official Name and Position | Prabahakar R Guniganti (OWNER) |
| Authorized Official Contact | 9365601844 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nacogdoches Heart Clinic, Pa 1303 N Mound St Nacogdoches TX 75961-4030 Ph: (936) 560-1844 | Nacogdoches Heart Clinic, Pa 1303 N Mound St Nacogdoches TX 75961-4030 Ph: (936) 560-1844 |
| NPI Number | 1609895861 |
|---|---|
| Provider Enumeration Date | 07/19/2006 |
| Last Update Date | 02/12/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609895861 | NPI | - | NPPES |
| 082003702 | Medicaid | TX | |
| 00D17C | Other | TX | BLUE CROSS PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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