Provider Demographics
NPI:1093338030
Name:NATURAL STATE AESTHETICS PLLC
Entity Type:Organization
Organization Name:NATURAL STATE AESTHETICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HANS
Authorized Official - Middle Name:B
Authorized Official - Last Name:HEYMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-739-9376
Mailing Address - Street 1:613 N WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-3550
Mailing Address - Country:US
Mailing Address - Phone:361-739-9376
Mailing Address - Fax:
Practice Address - Street 1:613 N WILLOW AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-3550
Practice Address - Country:US
Practice Address - Phone:361-739-9376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Single Specialty