Provider Demographics
NPI:1093944845
Name:ANDEREGG, HEATHER (O D)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:ANDEREGG
Suffix:
Gender:F
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 294869
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78029-4869
Mailing Address - Country:US
Mailing Address - Phone:830-257-4417
Mailing Address - Fax:830-257-1480
Practice Address - Street 1:1001 WATER ST STE E-100
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-3761
Practice Address - Country:US
Practice Address - Phone:830-257-4417
Practice Address - Fax:830-257-1480
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7390T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist