Healthcare Provider Details
I. General information
NPI: 1720253115
Provider Name (Legal Business Name): HEATHER BROOKS AVELAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/25/2008
Last Update Date: 02/22/2023
Certification Date: 02/22/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7505 MAIN ST STE 300
HOUSTON TX
77030-4523
US
IV. Provider business mailing address
104 WHISPERING PINES AVE
FRIENDSWOOD TX
77546-4911
US
V. Phone/Fax
- Phone: 281-885-8469
- Fax:
- Phone: 713-429-5325
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | R1494 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0805X |
| Taxonomy | Geriatric Psychiatry Physician |
| License Number | R1494 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: