Provider Demographics
NPI:1396305694
Name:VICK, HEATHER (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:VICK
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 COUNTY ROAD 389
Mailing Address - Street 2:
Mailing Address - City:EL CAMPO
Mailing Address - State:TX
Mailing Address - Zip Code:77437-3358
Mailing Address - Country:US
Mailing Address - Phone:979-541-3223
Mailing Address - Fax:
Practice Address - Street 1:6445 MAIN ST FL 24
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1502
Practice Address - Country:US
Practice Address - Phone:713-441-9948
Practice Address - Fax:713-441-8791
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143765363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner