Provider Demographics
NPI:1386150985
Name:CARDIOVASCULAR INSTITUTE OF SOUTH TEXAS, PLLC
Entity type:Organization
Organization Name:CARDIOVASCULAR INSTITUTE OF SOUTH TEXAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP AND CO-PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:TZY SHIUAN
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:KUO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-920-8000
Mailing Address - Street 1:12340 BANDERA RD STE 104
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4575
Mailing Address - Country:US
Mailing Address - Phone:210-920-8000
Mailing Address - Fax:210-920-6000
Practice Address - Street 1:12340 BANDERA RD STE 104
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023
Practice Address - Country:US
Practice Address - Phone:210-920-8000
Practice Address - Fax:210-920-6000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-18
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX40408753OtherDRIVERS LICENSE