Provider Demographics
NPI:1225057060
Name:HEBNER, CLAIRE M (MD)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:M
Last Name:HEBNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 S CONGRESS AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1156
Mailing Address - Country:US
Mailing Address - Phone:512-785-8282
Mailing Address - Fax:
Practice Address - Street 1:4201 S CONGRESS AVE STE 202
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1156
Practice Address - Country:US
Practice Address - Phone:512-502-5205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0086208000000X
WAMD000376522080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAUS7557043OtherAETNA/USHC SPECIALIST
WA6204HEOtherBLUE SHIELD
WA8247041Medicaid
TX195387901Medicaid
TX195387902Medicaid
TX195387903Medicaid
WA0039577OtherLABOR & INDUSTRY
WA6204HEOtherBLUE SHIELD
WA0039577OtherLABOR & INDUSTRY
H05765Medicare UPIN
TX8L5660Medicare PIN
WA8247041Medicaid