Individual
JENNIFER C HEATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6410 SOUTHWEST BLVD #101, FORT WORTH, TX 76109
(817) 735-1888
Mailing address
PO BOX 2710, COPPELL, TX 75019
(972) 258-9570
(972) 258-9569
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
J6998
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0098BW
BLUE CROSS BLUE SHIELD
TX
05
—
113817401
—
TX
01
—
260035942
MEDICARE RAILROAD
TX
Enumeration date
08/08/2006
Last updated
07/07/2008
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