Provider Demographics
NPI:1275845661
Name:HEEG, PAUL TIMOTHY (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:TIMOTHY
Last Name:HEEG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S DENTON TAP RD STE 204
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5039
Mailing Address - Country:US
Mailing Address - Phone:972-745-8760
Mailing Address - Fax:866-925-8070
Practice Address - Street 1:851 STATE HIGHWAY 121 BYP
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4158
Practice Address - Country:US
Practice Address - Phone:972-315-9306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7559TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist