Provider Demographics
NPI:1821663329
Name:HEINEN, BARBARA (PA-C)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:HEINEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 S COLLINS RD STE 800
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-4652
Mailing Address - Country:US
Mailing Address - Phone:832-217-4033
Mailing Address - Fax:
Practice Address - Street 1:182 S COLLINS RD STE 800
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-4652
Practice Address - Country:US
Practice Address - Phone:469-242-2383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA14556363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant