Healthcare Provider Details

I. General information

NPI: 1801800966
Provider Name (Legal Business Name): LINDA S HEARNE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N SANTA ROSA AVE SUITE 4671
SAN ANTONIO TX
78207-3108
US

IV. Provider business mailing address

2300 W COMMERCE ST SUITE 300
SAN ANTONIO TX
78207-3839
US

V. Phone/Fax

Practice location:
  • Phone: 210-738-8222
  • Fax: 210-738-8644
Mailing address:
  • Phone: 210-922-0103
  • Fax: 210-922-0162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH2525
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: