1134211212 NPI number — HEATHER LEIGH AKINS D.O.

Table of content: HEATHER LEIGH AKINS D.O. (NPI 1134211212)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134211212 NPI number — HEATHER LEIGH AKINS D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AKINS
Provider First Name:
HEATHER
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HORNE
Provider Other First Name:
HEATHER
Provider Other Middle Name:
LEIGH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134211212
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4001 W. 15TH STREET
Provider Second Line Business Mailing Address:
SUITE 445
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75093-5844
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-599-2567
Provider Business Mailing Address Fax Number:
972-599-2119

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4001 W. 15TH STREET
Provider Second Line Business Practice Location Address:
SUITE 445
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75093-5844
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-599-2567
Provider Business Practice Location Address Fax Number:
972-599-2119
Provider Enumeration Date:
09/28/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  L0743 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)