Individual
HEATHER BOWDRE HAGLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5206 RESEARCH DR, SAN ANTONIO, TX 78240-5251
(210) 595-5300
(210) 595-5301
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-0819
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA06071
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
347376103
—
TX
Enumeration date
03/30/2009
Last updated
10/07/2019
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