Healthcare Provider Details

I. General information

NPI: 1528478773
Provider Name (Legal Business Name): HEATHER MOSIER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 BRIGGS ST STE 990
SAN ANTONIO TX
78224-1287
US

IV. Provider business mailing address

1700 WOODGATE DR
WACO TX
76712-8600
US

V. Phone/Fax

Practice location:
  • Phone: 210-226-9536
  • Fax:
Mailing address:
  • Phone: 254-666-5454
  • Fax: 254-666-5459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number113939
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: