Provider Demographics
NPI:1639192016
Name:ECKHART, HEATHER NICOLE (NP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:NICOLE
Last Name:ECKHART
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6564 CR 302
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:76050
Mailing Address - Country:US
Mailing Address - Phone:817-846-0536
Mailing Address - Fax:
Practice Address - Street 1:6310 LYNDON B JOHNSON FWY
Practice Address - Street 2:STE 208
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6401
Practice Address - Country:US
Practice Address - Phone:888-385-0281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX595487363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S28647Medicare UPIN