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NPI Code Detail

MEDICARE: JAMES HEAP

MEDICARE: JAMES HEAP
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
1207Q00000XFamily Medicine PhysicianBP10054653TX
2207Q00000XFamily Medicine Physician54657AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417338880
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES HEAP
Provider Business Mailing Address
First Line : 1600 PROVIDENCE DR
Second Line : ATTN: TRACI MITCHELL - ADMN
City : WACO
State : TX
Zip : 76707-2261
Country : US
Telephone Number : 254-313-4200
Fax Number : 254-313-4326
Provider Business Practice Location Address
First Line : 606 N MAIN ST
Second Line :
City : EAGAR
State : AZ
Zip : 85925-9813
Country : US
Telephone Number : 928-333-5333
Fax Number : 928-333-5100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2015
Last Update Date : 09/04/2018

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Directions to “ JAMES HEAP ” Practice Location

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