Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 2030 | TX |
Y | 222Z00000X | Podiatrist | 2030 | TX |
N | 213ES0103X | Foot & Ankle Surgery | PR175 | FL |
NPI | 1003144593 |
---|---|
Provider Name | Dr. Tyreen Vidal Heybeck |
First Address | Kingwood, TX 77339-3750 |
Second Address | Kingwood, TX 77339-3750 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2009 |
Last Update Date | 13/08/2012 |