Provider Demographics
NPI:1619399359
Name:HEATH, DARREN RAMON (LSA)
Entity Type:Individual
Prefix:MR
First Name:DARREN
Middle Name:RAMON
Last Name:HEATH
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SUGAR CREEK CENTER BLVD STE 618
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3540
Mailing Address - Country:US
Mailing Address - Phone:832-655-4141
Mailing Address - Fax:713-457-5188
Practice Address - Street 1:1 SUGAR CREEK CENTER BLVD STE 618
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3540
Practice Address - Country:US
Practice Address - Phone:832-655-4141
Practice Address - Fax:832-655-4141
Is Sole Proprietor?:No
Enumeration Date:2014-01-15
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSA0052246ZC0007X
TXSA00594246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8HM675OtherBCBS - UNIVERSAL SURGICAL ASSISTANTS
TX8HM676OtherBCBS - UNIVERSAL SURGICAL PARTNERS
TX8HM677OtherBCBS - XCITE SURGICAL LLC
TX8LH811OtherBCBS - BLUE STAR SURGICAL ASSISTANTS LLC
TXSA0052OtherTEXAS MEDICAL BOARD