Provider Demographics
NPI:1043412471
Name:BROOKS-HEINZMAN, ALISON JEANNE (MD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:JEANNE
Last Name:BROOKS-HEINZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 RIO GRANDE ST STE 340
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1162
Mailing Address - Country:US
Mailing Address - Phone:512-795-5500
Mailing Address - Fax:512-795-3502
Practice Address - Street 1:1313 RED RIVER ST STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1923
Practice Address - Country:US
Practice Address - Phone:512-324-8600
Practice Address - Fax:512-324-8616
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5648207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CW762OtherBCBS
TX197743103Medicaid
TX197743103Medicaid