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Individual

MRS. MARY ELIZABETH VON HEILAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP-PC

Contact information

Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-4000
Mailing address
7703 FLOYD CURL DRIVE, MC7740, SAN ANTONIO, TX 78229-3900
(210) 743-4130
(210) 702-6292

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
744123
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
345210401
TX
Enumeration date
03/31/2015
Last updated
07/07/2015
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