Healthcare Provider Details

I. General information

NPI: 1679511653
Provider Name (Legal Business Name): MARGARET A VON HEUVEL G.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25145 STAR LN STE 705
KATY TX
77494-7088
US

IV. Provider business mailing address

PO BOX 1109
KATY TX
77492-1109
US

V. Phone/Fax

Practice location:
  • Phone: 346-307-7500
  • Fax: 346-307-7570
Mailing address:
  • Phone: 346-307-7500
  • Fax: 346-307-7570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number633569
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number633569
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number633569
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: