Provider Demographics
NPI:1295961084
Name:HEAPS, TERRY M (LIC AC - DIPL OM)
Entity type:Individual
Prefix:MS
First Name:TERRY
Middle Name:M
Last Name:HEAPS
Suffix:
Gender:F
Credentials:LIC AC - DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3060 GESSNER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-2508
Mailing Address - Country:US
Mailing Address - Phone:713-922-6097
Mailing Address - Fax:
Practice Address - Street 1:3060 GESSNER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-2508
Practice Address - Country:US
Practice Address - Phone:713-922-6097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-07
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01138171100000X
AZ0997171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist