Provider Demographics
NPI:1891999470
Name:RIEBEL, HEATHER R (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:R
Last Name:RIEBEL
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 1:8267 PIMLICO LN
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78015-4455
Mailing Address - Country:US
Mailing Address - Phone:434-981-3374
Mailing Address - Fax:
Practice Address - Street 1:34910 INTERSTATE 10 W STE 501
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-9230
Practice Address - Country:US
Practice Address - Phone:830-484-6111
Practice Address - Fax:830-331-9806
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP49032080P0202X, 208000000X
VA01012606282080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX314702703Medicaid
TX3147027Medicaid