Provider Demographics
NPI:1992100499
Name:HEIL, SHAUNA MARIE (DC)
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:MARIE
Last Name:HEIL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:MARIE
Other - Last Name:WEIGAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12888 QUEENSBURY LN
Mailing Address - Street 2:302
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2094
Mailing Address - Country:US
Mailing Address - Phone:832-301-1098
Mailing Address - Fax:
Practice Address - Street 1:10497 TOWN AND COUNTRY WAY
Practice Address - Street 2:360
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1117
Practice Address - Country:US
Practice Address - Phone:832-917-8545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12672111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor