Provider Demographics
NPI:1861453433
Name:HECKER-RODRIGUEZ, MAUREEN JEAN (MD)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:JEAN
Last Name:HECKER-RODRIGUEZ
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 1:3800 HOUMA BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4151
Mailing Address - Country:US
Mailing Address - Phone:504-885-7360
Mailing Address - Fax:504-885-1360
Practice Address - Street 1:3800 HOUMA BLVD STE 205
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4151
Practice Address - Country:US
Practice Address - Phone:504-885-7360
Practice Address - Fax:504-885-1360
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.023107207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H04588Medicare UPIN
LA5E851Medicare ID - Type Unspecified