MEDICARE: HEATHER GAYLE SUTTON WALSH MD

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	207V00000X	Obstetrics & Gynecology Physician	L9539	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00470018	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	L9539	OTHER	TX	STATE MEDICAL LICENSE

General Provider Information

NPI Number	:	1871512640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER GAYLE SUTTON WALSH MD

Provider Business Mailing Address
First Line	:	2665 SCRIPTURE STREET
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76201
Country	:	US
Telephone Number	:	940-535-5767
Fax Number	:	940-898-0147

Provider Business Practice Location Address
First Line	:	2665 SCRIPTURE STREET
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76201-3708
Country	:	US
Telephone Number	:	940-535-5767
Fax Number	:	940-898-0147

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	07/05/2013

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Directions to “ HEATHER GAYLE SUTTON WALSH MD” Practice Location

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