Provider Demographics
NPI:1962828012
Name:HIERHOLZER ENTERPRISE, LLC
Entity Type:Organization
Organization Name:HIERHOLZER ENTERPRISE, LLC
Other - Org Name:STAR WELLNESS SAN ANTONIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:HIERHOLZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-331-8007
Mailing Address - Street 1:109 RETAMA ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006
Mailing Address - Country:US
Mailing Address - Phone:830-331-8007
Mailing Address - Fax:830-331-8007
Practice Address - Street 1:109 RETAMA ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006
Practice Address - Country:US
Practice Address - Phone:830-331-8007
Practice Address - Fax:830-331-8007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare