Provider Demographics
NPI:1205183407
Name:VANDERBROOK, HEIDI MCMAHAN (NP-C)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:MCMAHAN
Last Name:VANDERBROOK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8222 DOUGLAS AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5937
Mailing Address - Country:US
Mailing Address - Phone:972-993-5040
Mailing Address - Fax:
Practice Address - Street 1:8222 DOUGLAS AVE STE 600
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5937
Practice Address - Country:US
Practice Address - Phone:972-993-5040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX765415363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily