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General NPI Number Information
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NPI Number | 1326148651
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Entity Type | Individual
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Provider Name | THOMAS PATRICK HEFFERNAN MD
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Gender | Male
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 12200 PARK CENTRAL DR STE 410
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City | DALLAS
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State | TX
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Zip | 75251-2101
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Country | US
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Telephone | 972-490-5970
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Fax | 972-490-5632
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Provider Business Mailing Address
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Address Line | 800 W MAGNOLIA AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-4611
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Country | US
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Telephone | 817-759-7000
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Fax | 817-759-7027
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | M1752
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | M1752
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License Number State | TX
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