Healthcare Provider Details

I. General information

NPI: 1225910979
Provider Name (Legal Business Name): MONICA HECKMAN ATC, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 E NORTHGATE DR
IRVING TX
75062-9991
US

IV. Provider business mailing address

851 LAKE CAROLYN PKWY APT 467
IRVING TX
75039-4117
US

V. Phone/Fax

Practice location:
  • Phone: 972-721-5010
  • Fax:
Mailing address:
  • Phone: 937-423-4335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberAT7245
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: