Provider Demographics
NPI:1760481378
Name:HEARD, PATRICK C
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:C
Last Name:HEARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CHESTNUT ST
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-1453
Mailing Address - Country:US
Mailing Address - Phone:325-437-1001
Mailing Address - Fax:325-437-1005
Practice Address - Street 1:500 CHESTNUT ST
Practice Address - Street 2:SUITE 1001
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-1453
Practice Address - Country:US
Practice Address - Phone:325-437-1001
Practice Address - Fax:325-437-1005
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11856LPC101YP2500X
TX003831LMFT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0954117-01Medicaid