Organization
HERITAGE BIRTH CENTER, LLC
Active
Other names
Heritage Births
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDRA WYATT LM, CPM (OWNER)
(818) 421-1355
Entity
Organization
Contact information
Practice address
3410 KNOXVILLE AVE, LUBBOCK, TX 79413
(806) 224-8617
(806) 329-2632
Mailing address
3410 KNOXVILLE AVE, LUBBOCK, TX 79413
(806) 224-8617
(806) 329-2632
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
99178
TX
261QB0400X
Birthing Clinic/Center
150068
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
811042082
NPI
TX
Enumeration date
02/21/2018
Last updated
11/02/2020
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