Individual
DR. ROLAND HEIDENHOFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 E HARRIS AVE, SAN ANGELO, TX 76903-5904
(325) 657-5222
Mailing address
PO BOX 143333, IRVING, TX 75014-3333
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J5782
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8S0863
BCBS
TX
01
—
8V7083
BCBS
TX
Enumeration date
04/25/2006
Last updated
04/18/2008
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