Provider Demographics
NPI:1750787461
Name:HEITE, WILLIAM C (DVM)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:HEITE
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4021 ISLETA BLVD SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105-6132
Mailing Address - Country:US
Mailing Address - Phone:505-873-2590
Mailing Address - Fax:505-873-1773
Practice Address - Street 1:4021 ISLETA BLVD SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87105-6132
Practice Address - Country:US
Practice Address - Phone:505-873-2590
Practice Address - Fax:505-873-1773
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM357174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian