Healthcare Provider Details

I. General information

NPI: 1902276389
Provider Name (Legal Business Name): DEHEER HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2015
Last Update Date: 09/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1159 W JEFFERSON ST SUITE 204
FRANKLIN IN
46131-2794
US

IV. Provider business mailing address

PO BOX 9879
SPRING TX
77387-6879
US

V. Phone/Fax

Practice location:
  • Phone: 317-346-7722
  • Fax:
Mailing address:
  • Phone: 800-785-8765
  • Fax: 281-820-1901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: PATRICK A DEHEER
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 317-346-7722