Individual
JEFFREY S HEINLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6621 FANNIN ST, HOUSTON, TX 77030-2303
(832) 826-5731
(832) 825-1904
Mailing address
6621 FANNIN ST, HOUSTON, TX 77030-2303
(832) 826-5731
(832) 825-1905
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
K0820
TX
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
K0820
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102410103
—
TX
Enumeration date
10/17/2006
Last updated
03/04/2008
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