Individual
MR. DALE HEATHCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
107 W WAY ST, SUITE 19-20, LAKE JACKSON, TX 77566-5219
(979) 266-9497
(979) 266-9507
Mailing address
2502 PLATINUM CHASE DR, ROSHARON, TX 77583-3275
(281) 635-7458
(281) 778-5114
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Enumeration date
01/27/2017
Last updated
01/27/2017
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