Provider Demographics
NPI:1194863332
Name:HEATON, BARRY W
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:W
Last Name:HEATON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5858 WESTHEIMER RD
Mailing Address - Street 2:SUITE 820
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-5650
Mailing Address - Country:US
Mailing Address - Phone:713-784-6065
Mailing Address - Fax:713-784-6085
Practice Address - Street 1:5858 WESTHEIMER RD
Practice Address - Street 2:SUITE 820
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-5650
Practice Address - Country:US
Practice Address - Phone:713-784-6065
Practice Address - Fax:713-784-6085
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123611223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics