Provider Demographics
NPI:1467484741
Name:HECKER, STELLA (MD)
Entity type:Individual
Prefix:
First Name:STELLA
Middle Name:
Last Name:HECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:STELLA
Other - Last Name:TAYZON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2000 COOPER ST STE 120
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-2535
Mailing Address - Country:US
Mailing Address - Phone:817-820-2890
Mailing Address - Fax:817-810-0725
Practice Address - Street 1:2000 COOPER ST STE 120
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2535
Practice Address - Country:US
Practice Address - Phone:817-820-2890
Practice Address - Fax:817-810-0725
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7414207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH28424Medicare UPIN
TX0045BYMedicare ID - Type UnspecifiedGROUP MEDICARE #