Provider Demographics
NPI:1821057118
Name:ROBERT F HEBELER JR MD PA
Entity Type:Organization
Organization Name:ROBERT F HEBELER JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:HEBELER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:214-821-3603
Mailing Address - Street 1:8111 LBJ FREEWAY
Mailing Address - Street 2:STE 835
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251
Mailing Address - Country:US
Mailing Address - Phone:972-437-2577
Mailing Address - Fax:972-644-3810
Practice Address - Street 1:3409 WORTH STREET
Practice Address - Street 2:STE 720
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246
Practice Address - Country:US
Practice Address - Phone:214-821-3603
Practice Address - Fax:214-823-1317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146887801Medicaid
TX00557RMedicare PIN