HEROES HEALTHCARE PLLC NPI 1770184012

NPI Information

NPI: 1770184012
Provider Name: HEROES HEALTHCARE PLLC

Doing Business As: HEREOS HEALTHCARE PRIMARY CARE

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 45D2207092

Address:
8500 VILLAGE DR STE 202
SAN ANTONIO, TX
ZIP 78217
Phone: (210) 957-1419
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HEROES HEALTHCARE PLLC is a primary care clinic center in San Antonio, TX. HEROES HEALTHCARE PLLC NPI is 1770184012. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Hereos Healthcare Primary Care.

The provider's business location address is:

8500 VILLAGE DR STE 202
SAN ANTONIO, TX
ZIP 78217-510
Phone: (210) 957-1419
Fax: (210) 957-1697

The provider's authorized official is Trent J Fackelman .
The authorized official title is President/ceo and has the following contact phone number (210) 957-1419.

The CLIA number assigned to this NPI record is 45D2207092 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/3/2020 and was last updated on 8/15/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care			No
2	261QP2300X	Clinic/Center	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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