Provider Demographics
NPI:1326680158
Name:ACCESS PROVIDER GROUP, PLLC
Entity Type:Organization
Organization Name:ACCESS PROVIDER GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-773-5321
Mailing Address - Street 1:PO BOX 100145
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-1445
Mailing Address - Country:US
Mailing Address - Phone:833-922-1084
Mailing Address - Fax:
Practice Address - Street 1:3333 N FOSTER MALDONADO BLVD
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-5893
Practice Address - Country:US
Practice Address - Phone:833-922-1084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-14
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPENDINGMedicaid