Provider Demographics
NPI:1740792480
Name:HEYDARI, ANA LUISA (FNP)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:LUISA
Last Name:HEYDARI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:LUISA
Other - Last Name:NAJERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:919 HIDDEN RDG
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3813
Mailing Address - Country:US
Mailing Address - Phone:469-282-2711
Mailing Address - Fax:469-282-0996
Practice Address - Street 1:2120 S WAYSIDE DR STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77023-3900
Practice Address - Country:US
Practice Address - Phone:713-803-1840
Practice Address - Fax:713-926-5852
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135401363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily