Provider Demographics
NPI:1780825182
Name:HEARD, DANIEL T (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:T
Last Name:HEARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 TURNING LEAF DR
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77807-5117
Mailing Address - Country:US
Mailing Address - Phone:904-894-1725
Mailing Address - Fax:
Practice Address - Street 1:2030 TURNING LEAF DR
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77807-5117
Practice Address - Country:US
Practice Address - Phone:904-894-1725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02003589A208D00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program