Provider Demographics
NPI:1477346138
Name:HEATHER, HALEY (ATP)
Entity type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:
Last Name:HEATHER
Suffix:
Gender:F
Credentials:ATP
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:
Other - Last Name:BAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:590 CHERYL ST
Mailing Address - Street 2:
Mailing Address - City:PILOT POINT
Mailing Address - State:TX
Mailing Address - Zip Code:76258-1547
Mailing Address - Country:US
Mailing Address - Phone:870-692-1747
Mailing Address - Fax:
Practice Address - Street 1:4413 TYLER PARK DR STE A
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-3123
Practice Address - Country:US
Practice Address - Phone:903-592-3300
Practice Address - Fax:888-633-7575
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100138247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other