Provider Demographics
NPI:1053688127
Name:DR PAUL HEEG
Entity Type:Organization
Organization Name:DR PAUL HEEG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HEEG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-315-9306
Mailing Address - Street 1:851 STATE HIGHWAY 121 BYP
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4158
Mailing Address - Country:US
Mailing Address - Phone:972-315-9306
Mailing Address - Fax:
Practice Address - Street 1:851 STATE HIGHWAY 121 BYP
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4158
Practice Address - Country:US
Practice Address - Phone:972-315-9306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty