Provider Demographics
NPI:1225887029
Name:PHILLIPS, HEATHER ANNETTE
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNETTE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 S BROADWAY ST STE N
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-4888
Mailing Address - Country:US
Mailing Address - Phone:903-438-1600
Mailing Address - Fax:903-438-1600
Practice Address - Street 1:1217 S BROADWAY ST STE N
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-4888
Practice Address - Country:US
Practice Address - Phone:903-438-1600
Practice Address - Fax:903-438-1600
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80933237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist