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General NPI Number Information
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NPI Number | 1225295421
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Entity Type | Individual
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Provider Name | CHRISADEL G. HEATH MD
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Gender | Female
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3551 ROGER BROOKE DR
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City | JBSA FT SAM HOUSTON
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 210-539-9582
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Fax |
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Provider Business Mailing Address
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Address Line | 3551 ROGER BROOKE DR
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City | JBSA FT SAM HOUSTON
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 210-539-9582
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 22713
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 33484
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD.230588
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | Q6512
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License Number State | TX
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