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General NPI Number Information
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NPI Number | 1457705279
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Entity Type | Individual
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Provider Name | HEATHER WARK M.D., PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/18/2016
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 921 GESSNER RD
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City | HOUSTON
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State | TX
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Zip | 77024-2501
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Country | US
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Telephone | 713-242-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27128
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City | SALT LAKE CITY
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State | UT
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Zip | 84127-0128
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Country | US
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Telephone |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2025019458
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 10534809-1205
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | V7171
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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