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NPI Code Detail

MEDICARE: DR. HEATHER MICHELE WILMORE DDS

MEDICARE: DR. HEATHER MICHELE WILMORE DDS
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
11223G0001XGeneral Practice Dentistry23383TX

General Provider Information

NPI Number : 1932388907
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HEATHER MICHELE WILMORE DDS
Provider Business Mailing Address
First Line : 6300 WEST LOOP S STE 650
Second Line :
City : BELLAIRE
State : TX
Zip : 77401-2997
Country : US
Telephone Number : 713-663-7960
Fax Number : 713-349-8027
Provider Business Practice Location Address
First Line : 12052 EAST FWY
Second Line :
City : HOUSTON
State : TX
Zip : 77029-1916
Country : US
Telephone Number : 713-451-5700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2007
Last Update Date : 07/12/2011

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