Provider Demographics
NPI:1972625994
Name:HEYTENS, JILL E (MD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:E
Last Name:HEYTENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:900 W 38TH ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1127
Mailing Address - Country:US
Mailing Address - Phone:512-458-2600
Mailing Address - Fax:512-454-2292
Practice Address - Street 1:900 W 38TH ST
Practice Address - Street 2:SUITE 350
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1127
Practice Address - Country:US
Practice Address - Phone:512-458-2600
Practice Address - Fax:512-454-2292
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ75182084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF64292Medicare UPIN
TX80X821Medicare PIN