MEDICARE: DR. VICTORIA HEROLD DO

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	207Q00000X	Family Medicine Physician	LL36697	SC
2	207Q00000X	Family Medicine Physician	R2618	TX

General Provider Information

NPI Number	:	1659785830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTORIA HEROLD DO

Provider Business Mailing Address
First Line	:	255 W LEABANON RD, BUILDING A, SUITE 106
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75036-3412
Country	:	US
Telephone Number	:	469-294-0210
Fax Number	:

Provider Business Practice Location Address
First Line	:	255 W LEABANON RD, BUILDING A, SUITE 106
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75036-3412
Country	:	US
Telephone Number	:	469-294-0210
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2014
Last Update Date	:	10/03/2023

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Directions to “ DR. VICTORIA HEROLD DO” Practice Location

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