Provider Demographics
NPI:1366464273
Name:CYFAIR CARDIOLOGY ASSOC PA
Entity type:Organization
Organization Name:CYFAIR CARDIOLOGY ASSOC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERNIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-890-4886
Mailing Address - Street 1:255 ED ENGLISH DR STE B
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-8027
Mailing Address - Country:US
Mailing Address - Phone:281-890-4886
Mailing Address - Fax:281-894-2247
Practice Address - Street 1:255 ED ENGLISH DR STE B
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-8027
Practice Address - Country:US
Practice Address - Phone:281-890-4886
Practice Address - Fax:281-894-2247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX036183401Medicaid
TX036183401Medicaid