Provider Demographics
NPI:1598794802
Name:HECHT, PHILLIP JOEL (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:JOEL
Last Name:HECHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W COLLEGE ST
Mailing Address - Street 2:SUITE 680
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-3580
Mailing Address - Country:US
Mailing Address - Phone:817-912-8400
Mailing Address - Fax:817-912-8410
Practice Address - Street 1:1600 W COLLEGE ST
Practice Address - Street 2:SUITE 680
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3580
Practice Address - Country:US
Practice Address - Phone:817-912-8400
Practice Address - Fax:817-912-8410
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4393207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX044273307Medicaid
TX044273303Medicaid
TX044273304Medicaid
TX044273308Medicaid
TX044273309Medicaid
TX8CX374OtherBCBSTX
TX060065715Medicare PIN
TX044273308Medicaid
TX8741N4Medicare PIN
TX044273304Medicaid
TXP01010981Medicare PIN
TXTXB138544Medicare PIN
TX060065688Medicare PIN
TX044273307Medicaid
TX8739N5Medicare PIN
TX060065699Medicare PIN