Provider Demographics
NPI:1659785830
Name:HEROLD, VICTORIA (DO)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:HEROLD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 W LEABANON RD, BUILDING A, SUITE 106
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-3412
Mailing Address - Country:US
Mailing Address - Phone:469-294-0210
Mailing Address - Fax:
Practice Address - Street 1:255 W LEABANON RD, BUILDING A, SUITE 106
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036-3412
Practice Address - Country:US
Practice Address - Phone:469-294-0210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL36697207Q00000X
TXR2618207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty