Provider Demographics
NPI:1578666053
Name:LYN STERN, HEIDI (MD)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:LYN STERN
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 1:9180 PINECROFT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3880
Mailing Address - Country:US
Mailing Address - Phone:281-367-6836
Mailing Address - Fax:281-367-5545
Practice Address - Street 1:9180 PINECROFT DR STE 100
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3880
Practice Address - Country:US
Practice Address - Phone:281-367-6836
Practice Address - Fax:281-367-5545
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8650174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F9531OtherBCBS OF TEXAS
TX175467301Medicaid
TXG68911Medicare UPIN
TX175467301Medicaid