Individual
HEATHER MICHELLE FONTENOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSA
Contact information
Practice address
7900 FM 1826 BLDG 2, SUITE 206, AUSTIN, TX 78737-1407
(512) 288-8200
(521) 288-8207
Mailing address
7900 FARM TO MARKET ROAD 1826 BLDG 2, SUITE 206, AUSTIN, TX 78737
(512) 288-8200
(512) 288-8207
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
107080
TX
246ZC0007X
Surgical Assistant
Primary
SA00401
TX
246ZS0410X
Surgical Technologist
SA00401
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SA00401
LSA IDENTIFICATION NUMBER
TX
Enumeration date
11/02/2007
Last updated
05/24/2016
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