Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 620016 | TX |
NPI | 1114086006 |
---|---|
Provider Name | Bettina L Hebert |
First Address | Houston, TX 77030-1501 |
Second Address | Houston, TX 77030-1501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 22/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
184229601 | (05) | TX |
184229602 | CSHCN (01) | TX |
8Y1255 | BCBS (01) | TX |