Provider Demographics
NPI:1609287739
Name:EVANS, HEIDI (MD)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:
Other - Last Name:HOLTORF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2525 W BELLFORT AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-5024
Mailing Address - Country:US
Mailing Address - Phone:713-741-6677
Mailing Address - Fax:713-748-5860
Practice Address - Street 1:2525 W. BELFORT AVENUE, SUITE 120
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-5024
Practice Address - Country:US
Practice Address - Phone:713-741-6677
Practice Address - Fax:713-748-5860
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6024207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology