Provider Demographics
NPI:1558361923
Name:THAKKAR, HEENA NARENDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:HEENA
Middle Name:NARENDRA
Last Name:THAKKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 W 27TH ST
Mailing Address - Street 2:STE 305
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1440
Mailing Address - Country:US
Mailing Address - Phone:713-861-7400
Mailing Address - Fax:713-861-7762
Practice Address - Street 1:1740 W 27TH ST
Practice Address - Street 2:STE 305
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1440
Practice Address - Country:US
Practice Address - Phone:713-861-4800
Practice Address - Fax:713-861-7762
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4953208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00T971OtherBLUE CROSS / BLUE SHIELD
TX00T971OtherBLUE CROSS / BLUE SHIELD