Individual
HEATHER DYANE LAUER RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6606 LBJ FWY, SUITE 200, DALLAS, TX 75240-6533
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
696425
TX
372500000X
Chore Provider
Primary
AP121377
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
294317703
—
TX
01
—
8761UG
BCBS
TX
01
—
P01358214
RR
TX
Enumeration date
12/28/2011
Last updated
06/15/2020
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