Individual
HEATHER E DOUNTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3901 CARLISLE BLVD NE, ALBUQUERQUE, NM 87107
(505) 888-8500
(505) 888-8503
Mailing address
PO BOX 27829, ALBUQUERQUE, NM 87125
(505) 232-1920
(505) 727-9276
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA20040041
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83108726
—
NM
Enumeration date
07/08/2006
Last updated
07/08/2007
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