Provider Demographics
NPI:1932130739
Name:HEARN, CLAUDE DAVID (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDE
Middle Name:DAVID
Last Name:HEARN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MEDICAL CENTER BLVD
Mailing Address - Street 2:#101
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598
Mailing Address - Country:US
Mailing Address - Phone:281-332-4596
Mailing Address - Fax:281-332-9610
Practice Address - Street 1:200 MEDICAL CENTER BLVD
Practice Address - Street 2:#101
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598
Practice Address - Country:US
Practice Address - Phone:281-332-4596
Practice Address - Fax:281-332-9610
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9815208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8H0893OtherBLUE CROSS BLUE SHIELD
TXB23377Medicare UPIN
TX8H0893OtherBLUE CROSS BLUE SHIELD