=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003269903
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WHITNEY HEJNY OD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2016
-----------------------------------------------------
Last Update Date | 01/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3542A LOOP 306
-----------------------------------------------------
City | SAN ANGELO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76904-5944
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 325-653-0118
-----------------------------------------------------
Fax | 325-653-4347
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3542A LOOP 306
-----------------------------------------------------
City | SAN ANGELO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76904-5944
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 325-653-0118
-----------------------------------------------------
Fax | 325-653-4347
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 8989TG
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------