Provider Demographics
NPI:1124169024
Name:HECZKO, WILLIAM G (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:G
Last Name:HECZKO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 568
Mailing Address - Street 2:26 HWY 87
Mailing Address - City:COMFORT
Mailing Address - State:TX
Mailing Address - Zip Code:78013-0568
Mailing Address - Country:US
Mailing Address - Phone:830-995-2834
Mailing Address - Fax:830-995-3518
Practice Address - Street 1:26 HWY 27
Practice Address - Street 2:
Practice Address - City:COMFORT
Practice Address - State:TX
Practice Address - Zip Code:78013-0568
Practice Address - Country:US
Practice Address - Phone:830-995-2834
Practice Address - Fax:830-995-3518
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX127341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX050028OtherCHIPS