Provider Demographics
NPI:1275722720
Name:HEIGHTS DOCTORS CLINIC PA
Entity type:Organization
Organization Name:HEIGHTS DOCTORS CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:REYNALDO
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-302-6816
Mailing Address - Street 1:709 W 42ND ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-4428
Mailing Address - Country:US
Mailing Address - Phone:713-894-2707
Mailing Address - Fax:713-529-4893
Practice Address - Street 1:709 W 42ND ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-4428
Practice Address - Country:US
Practice Address - Phone:713-894-2707
Practice Address - Fax:713-539-4893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7070174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00349RMedicare PIN