Individual
JACK N HEHMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1205 E 35TH ST, TEXARKANA, AR 71854-2746
(903) 735-5355
(903) 735-5399
Mailing address
PO BOX 811, TEXARKANA, TX 75504-0811
(903) 735-5355
(903) 735-5399
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA03299
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8N4180
BLUE CROSS
TX
01
—
970025486
RAILROAD MEDICARE
—
01
—
PA-193
LICENSE
AR
Enumeration date
09/22/2005
Last updated
03/26/2008
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