Provider Demographics
NPI:1053532010
Name:COLONY HEART CENTER, P.A.
Entity type:Organization
Organization Name:COLONY HEART CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:PEPPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-265-8855
Mailing Address - Street 1:4610 SWEETWATER BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3152
Mailing Address - Country:US
Mailing Address - Phone:281-265-8855
Mailing Address - Fax:281-265-4327
Practice Address - Street 1:4610 SWEETWATER BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3152
Practice Address - Country:US
Practice Address - Phone:281-265-8855
Practice Address - Fax:281-265-4327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8812207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0027JYOtherBCBS PROVIDER NUMBER
TX00981UMedicare ID - Type Unspecified
TX0027JYOtherBCBS PROVIDER NUMBER