Provider Demographics
NPI:1407156805
Name:HERRERA, HEATHER E (PNP- AC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:E
Last Name:HERRERA
Suffix:
Gender:F
Credentials:PNP- AC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:E
Other - Last Name:BILLINGSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP- AC
Mailing Address - Street 1:315 N SAN SABA
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-3154
Mailing Address - Country:US
Mailing Address - Phone:210-704-3049
Mailing Address - Fax:
Practice Address - Street 1:333 N SANTA ROSA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3108
Practice Address - Country:US
Practice Address - Phone:210-704-2965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX702709363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218308902OtherCSHCN
TX218308901Medicaid
TXTXB117872Medicare PIN