Organization
EAGLE MOUNTAIN HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER GRAYSON AGNP (NURSE PRACTITIONER/OWNER)
(817) 661-8197
Entity
Organization
Contact information
Practice address
807 SOUTHEAST PKWY, AZLE, TX 76020-3658
(817) 661-8197
Mailing address
807 SOUTHEAST PKWY, AZLE, TX 76020-3658
(817) 661-8197
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/10/2023
Last updated
03/03/2025
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