Healthcare Provider Details

I. General information

NPI: 1891182176
Provider Name (Legal Business Name): HEIDI SWANSON-FELLOWS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2015
Last Update Date: 04/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8196 WALNUT HILL LN CANCER CENTER, SUITE 120
DALLAS TX
75231-4452
US

IV. Provider business mailing address

8196 WALNUT HILL LN CANCER CENTER, SUITE 120
DALLAS TX
75231-4452
US

V. Phone/Fax

Practice location:
  • Phone: 214-345-6625
  • Fax: 214-345-4219
Mailing address:
  • Phone: 214-345-6625
  • Fax: 214-345-4219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: