Individual
DR. GLEN WAYNE HECKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3801 GASTON AVENUE, SUITE 200, DALLAS, TX 75246-1619
(214) 823-9630
(214) 821-3556
Mailing address
9514 MOSS HAVEN DR, DALLAS, TX 75231-2608
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
F9547
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113952903
—
TX
Enumeration date
01/04/2006
Last updated
10/05/2011
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