Provider Demographics
NPI:1821065038
Name:DALEY, HEARTHER ASNETH (MD)
Entity Type:Individual
Prefix:
First Name:HEARTHER
Middle Name:ASNETH
Last Name:DALEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E RIDGE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1528
Mailing Address - Country:US
Mailing Address - Phone:956-688-5922
Mailing Address - Fax:956-688-5920
Practice Address - Street 1:1200 E RIDGE RD
Practice Address - Street 2:STE 3
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1528
Practice Address - Country:US
Practice Address - Phone:956-688-5922
Practice Address - Fax:956-688-5920
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9514207VX0000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX372843801OtherTPI
TX479228ZTSLOtherMEDICARE PTAN
1427258912OtherGROUP NPI