Provider Demographics
NPI:1053375451
Name:CARDIAC PERFUSION SERVICES, INC
Entity type:Organization
Organization Name:CARDIAC PERFUSION SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-827-9077
Mailing Address - Street 1:4612 GASTON AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1010
Mailing Address - Country:US
Mailing Address - Phone:214-827-9077
Mailing Address - Fax:214-827-9289
Practice Address - Street 1:4612 GASTON AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1010
Practice Address - Country:US
Practice Address - Phone:214-827-9077
Practice Address - Fax:214-827-9289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies