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Individual

KEITH A HEIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4780 N JOSEY LN, CARROLLTON, TX 75010-4615
(972) 492-1334
(972) 492-5174
Mailing address
4780 N JOSEY LN, CARROLLTON, TX 75010-4615
(972) 492-1334
(972) 492-5174

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
J9088
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
J9088
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104467903
TX
01
6484850003
MEDICARE NSC - EFFECT 02/01/2011
TX
01
8B7874
BCBS
01
8CR162
BCBS TX 02/01/2011
TX
01
P00913371
MEDICARE RAILROAD - EFFECT 02/01/2011
TX
01
TXB117515
MEDICARE PART B - EFFECT 02/01/2011
TX
Enumeration date
07/12/2006
Last updated
02/01/2017
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