Provider Demographics
NPI:1891963328
Name:DALLAS CARDIOVASCULAR SURGICAL ASSOCIATION
Entity type:Organization
Organization Name:DALLAS CARDIOVASCULAR SURGICAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:G
Authorized Official - Last Name:CHANG-TUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-361-2300
Mailing Address - Street 1:11808 FOREST LAKES LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2858
Mailing Address - Country:US
Mailing Address - Phone:214-361-2300
Mailing Address - Fax:
Practice Address - Street 1:6130 W PARKER RD STE 103
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7910
Practice Address - Country:US
Practice Address - Phone:214-361-2300
Practice Address - Fax:214-361-2316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4907208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty