Provider Demographics
NPI:1093043069
Name:WESSNER, HEATHER R (PHARM D)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:R
Last Name:WESSNER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7216 OVERLAND TRL
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-7017
Mailing Address - Country:US
Mailing Address - Phone:412-913-7552
Mailing Address - Fax:
Practice Address - Street 1:705 BOYD RD
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-4811
Practice Address - Country:US
Practice Address - Phone:817-444-2984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47052183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist