MEDICARE: HEIRINE HEALTHCARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1114454485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEIRINE HEALTHCARE INC

Provider Business Mailing Address
First Line	:	6709 PARKHURST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77028-4413
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6709 PARKHURST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77028-4413
Country	:	US
Telephone Number	:	281-717-3099
Fax Number	:

Authorized Official
Title or Position	:	LCSW
Name	:	HEIDI MANDL
Credential	:
Telephone Number	:	281-717-3099

Provider Enumeration Date	:	05/17/2017
Last Update Date	:	05/17/2017

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Directions to “HEIRINE HEALTHCARE INC ” Practice Location

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