Provider Demographics
NPI:1013352467
Name:BEARD, HEATHER B (RD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:B
Last Name:BEARD
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:M
Other - Last Name:BOURGEOIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1216 HERITAGE PKWY S
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-5768
Mailing Address - Country:US
Mailing Address - Phone:972-533-6159
Mailing Address - Fax:
Practice Address - Street 1:1216 HERITAGE PKWY S
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-5768
Practice Address - Country:US
Practice Address - Phone:972-533-6159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80589133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered