Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | S9557 | TX |
NPI | 1346635620 |
---|---|
Provider Name | Dr. Heather Ann Mcmahon |
First Address | Houston, TX 77210-4439 |
Second Address | Houston, TX 77030-4000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2015 |
Last Update Date | 20/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
426939101 | (05) | TX |
426939102 | CSHCN MEDICAID (01) | TX |