MEDICARE: DR. DELBERT LEON HESKETT M.D.

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	207L00000X	Anesthesiology Physician	L8074	TX

General Provider Information

NPI Number	:	1235116211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DELBERT LEON HESKETT M.D.

Provider Business Mailing Address
First Line	:	13601 PRESTON RD
Second Line	:	SUITE 900W
City	:	DALLAS
State	:	TX
Zip	:	75240-4911
Country	:	US
Telephone Number	:	972-233-1999
Fax Number	:	972-386-4292

Provider Business Practice Location Address
First Line	:	1650 W COLLEGE ST
Second Line	:
City	:	GRAPEVINE
State	:	TX
Zip	:	76051-3565
Country	:	US
Telephone Number	:	817-329-2851
Fax Number	:	817-424-4528

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

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	07/08/2007

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