=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821065038
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HEARTHER ASNETH DALEY M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2006
-----------------------------------------------------
Last Update Date | 01/04/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1200 E RIDGE RD STE 3
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78503-1528
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-688-5922
-----------------------------------------------------
Fax | 956-688-5920
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1200 E RIDGE RD STE 3
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78503-1528
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-688-5922
-----------------------------------------------------
Fax | 956-688-5920
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207VX0000X
-----------------------------------------------------
Taxonomy Name | Obstetrics Physician
-----------------------------------------------------
License Number | K9514
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | K9514
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------