Individual
HEATHER LILLEMOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-6161
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
T0840
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
428281601
—
TX
01
—
428281602
CSHCN
TX
Enumeration date
04/15/2014
Last updated
11/04/2021
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