Provider Demographics
NPI:1104265198
Name:HEBERTON, GEORGE A (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:A
Last Name:HEBERTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 N HALL ST STE 500
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75226-1301
Mailing Address - Country:US
Mailing Address - Phone:469-800-7400
Mailing Address - Fax:469-800-7410
Practice Address - Street 1:621 N HALL ST STE 500
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1301
Practice Address - Country:US
Practice Address - Phone:469-800-7400
Practice Address - Fax:469-800-7410
Is Sole Proprietor?:No
Enumeration Date:2013-06-23
Last Update Date:2022-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR1962207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology