Provider Demographics
NPI:1275876484
Name:HEATHER INTERNATIONAL GROUP LLC
Entity Type:Organization
Organization Name:HEATHER INTERNATIONAL GROUP LLC
Other - Org Name:HEATHER DIAGNOSTIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:AIJAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-822-1555
Mailing Address - Street 1:9898 BISSONNET ST
Mailing Address - Street 2:362
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8270
Mailing Address - Country:US
Mailing Address - Phone:281-822-1555
Mailing Address - Fax:281-822-1556
Practice Address - Street 1:9898 BISSONNET ST STE 362
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8025
Practice Address - Country:US
Practice Address - Phone:281-822-1555
Practice Address - Fax:281-822-1556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-05
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246X00000X
TX12345AJ251B00000X, 251X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251X00000XAgenciesSupports BrokerageGroup - Multi-Specialty