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Individual

AUSTIN E HEERSCHAP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5000 LONG PRAIRIE RD, FLOWER MOUND, TX 75028-2783
(972) 420-1776
(972) 221-8685
Mailing address
5000 LONG PRAIRIE RD, FLOWER MOUND, TX 75028-2783
(972) 420-1776
(972) 221-8685

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA09386
TX
363AM0700X
Medical Physician Assistant
Primary
PA09386
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00317Y
MEDICARE PTAN EMPLOYER
01
1477830677
NPI TYPE 2 GROUP EMPLOYER
TX
01
1588749766
NPI TYPE 2 GROUP EMPLOYER
TX
01
385783YK02
MEDICARE PTAN INDIVIDUAL
TX
01
PA09386
PA LICENSE
TX
Enumeration date
12/16/2014
Last updated
02/19/2015
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