Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 102490 | TX |
NPI | 1245257278 |
---|---|
Provider Name | Sheila Heflin |
First Address | Corpus Christi, TX 78411-4838 |
Second Address | Corpus Christi, TX 78411-4838 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
81479T | BLUE CROSS / BLUE SHIELD (01) | TX |