HeartPlace Southlake is conveniently located on the Texas Health Harris Methodist Hospital Southlake campus. We have a wonderful group of physicians ready to serve you. Call us today for your appointment. We look forward to meeting you and starting your journey to a healthy heart.

1545 East Southlake Boulevard
Suite 250
Southlake, Texas 76092

Phone: 682-223-9112
Fax: 844-289-7683

Location Hours: 8:30 am - 5:00 pm (Monday - Thursday)

                              8:30 am - 4:00 pm (Friday)


Southlake Clinic Providers

Andrew H. Miller, MD, FACC
Ali Moustapha, MD, FACC
Iyad Rashdan, MD
Alisa Thamwiwat, MD, FACC
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Southlake Clinic Forms

For your convenience, we have placed various patient forms below, in the form of PDF files that you may download at your leisure. Once they have been completed, you can either mail or fax them to this office, or bring them with you to your appointment.

HeartPlace Southlake Clinic Fax #: 844-289-7683

You will need the Adobe Reader to view and print these documents.


Full Patient Visit Packets

Individual Patient Visit Forms

Patient Testing Instructions

Patient Procedure Instructions



"Friendly, courteous personnel."

Google Reviews ~ Jose C.


HeartPlace - Administation Office

16980 Dallas Pkwy, Suite 200, Dallas, TX 75248

16980 Dallas Pkwy, Suite 200, Dallas, TX 75248

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All Rights Reserved.