Provider Demographics
NPI:1477581197
Name:HEIMERDINGER, KATHERINE ANNE (PT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANNE
Last Name:HEIMERDINGER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 BROWN CLIFF CT
Mailing Address - Street 2:
Mailing Address - City:DOUBLE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75077-8474
Mailing Address - Country:US
Mailing Address - Phone:817-961-0153
Mailing Address - Fax:
Practice Address - Street 1:2318 SAN JACINTO BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-7535
Practice Address - Country:US
Practice Address - Phone:940-380-9111
Practice Address - Fax:940-380-9112
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1136976225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist