Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | K5114 | TX |
NPI | 1104891365 |
---|---|
Provider Name | Dr. Anna Henry Heisser |
First Address | San Antonio, TX 78240-3900 |
Second Address | San Antonio, TX 78240-3900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 11/04/2008 |