Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MDH7065 | TX |
NPI | 1023071859 |
---|---|
Provider Name | Dr. Dalton David Heath |
First Address | Huntsville, TX 77340-4982 |
Second Address | Huntsville, TX 77340-4982 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2006 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00252T | BC (01) | TX |