Provider Demographics
NPI:1063630416
Name:THE HEART CLINIC
Entity type:Organization
Organization Name:THE HEART CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTINEZ SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-383-1721
Mailing Address - Street 1:1120 S CLOSNER BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-5662
Mailing Address - Country:US
Mailing Address - Phone:956-383-1721
Mailing Address - Fax:956-383-2352
Practice Address - Street 1:1120 S CLOSNER BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5662
Practice Address - Country:US
Practice Address - Phone:956-383-1721
Practice Address - Fax:956-383-2352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2281207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080987301Medicaid
TX133179505Medicaid
TX00677KOtherBLUE CROSS BLUE SHIELD
TXE2281OtherTX MEDICAL LISC NUMBER
TXE2281OtherTX MEDICAL LISC NUMBER
TX00677KOtherBLUE CROSS BLUE SHIELD
TX00677KMedicare ID - Type UnspecifiedGROUP NUMBER
TX080987301Medicaid