Provider Demographics
NPI:1174286926
Name:HEROES HEALING OTHERS
Entity Type:Organization
Organization Name:HEROES HEALING OTHERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FLIGHT SURGEON
Authorized Official - Phone:240-476-7065
Mailing Address - Street 1:1811 RALLY LN
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-6032
Mailing Address - Country:US
Mailing Address - Phone:240-476-7065
Mailing Address - Fax:
Practice Address - Street 1:1811 RALLY LN
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-6032
Practice Address - Country:US
Practice Address - Phone:240-476-7065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care