MEDICARE: DR. FRANCIS LOUIS HEYDE II D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	16194	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D16194	OTHER		BCBS PROVIDER #

General Provider Information

NPI Number	:	1063595791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCIS LOUIS HEYDE II D.D.S.

Provider Business Mailing Address
First Line	:	2806 N NAVARRO ST
Second Line	:	SUITE F
City	:	VICTORIA
State	:	TX
Zip	:	77901-3918
Country	:	US
Telephone Number	:	361-573-9923
Fax Number	:

Provider Business Practice Location Address
First Line	:	2806 N NAVARRO ST
Second Line	:	SUITE F
City	:	VICTORIA
State	:	TX
Zip	:	77901-3918
Country	:	US
Telephone Number	:	361-573-9923
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	07/08/2007

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