Individual
MRS. HEATHER L. BRAUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
405 LONDONDERRY DR, SUITE 200, WACO, TX 76712-7924
(254) 537-6400
(254) 537-6402
Mailing address
PO BOX 18962, BELFAST, ME 04915-4084
(180) 056-6505
(254) 537-6869
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2150
OK
363A00000X
Physician Assistant
Primary
PA 09188
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200440810A
—
OK
Enumeration date
07/02/2012
Last updated
01/09/2017
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