Provider Demographics
NPI:1518218171
Name:GILMORE, HEATHER BELINDA (CST, CSA)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:BELINDA
Last Name:GILMORE
Suffix:
Gender:F
Credentials:CST, CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 OAK RD
Mailing Address - Street 2:APT. 5207
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8853
Mailing Address - Country:US
Mailing Address - Phone:832-475-5720
Mailing Address - Fax:
Practice Address - Street 1:2850 OAK RD
Practice Address - Street 2:APT. 5207
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8853
Practice Address - Country:US
Practice Address - Phone:832-475-5720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist