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General NPI Number Information
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NPI Number | 1861062739
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Entity Type | Individual
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Provider Name | HEATHER MATHESON L.AC.
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Gender | Female
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Dates
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Enumeration Date | 07/01/2021
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Last Update Date | 08/28/2021
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Provider Practice Location Address
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Address Line | 21707 KINGSLAND BLVD STE 104
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City | KATY
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State | TX
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Zip | 77450-2519
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Country | US
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Telephone | 832-321-3288
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Fax | 832-722-4517
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Provider Business Mailing Address
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Address Line | 2815 FALCON KNOLL LN
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City | KATY
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State | TX
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Zip | 77494-2423
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Country | US
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Telephone | 281-731-7494
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Fax | 832-772-4517
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC01893
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License Number State | TX
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