Provider Demographics
NPI:1992707012
Name:HEINE, JON E (MD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:E
Last Name:HEINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 GESSNER RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2545
Mailing Address - Country:US
Mailing Address - Phone:713-467-0605
Mailing Address - Fax:713-467-3771
Practice Address - Street 1:925 GESSNER RD
Practice Address - Street 2:SUITE 400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2545
Practice Address - Country:US
Practice Address - Phone:713-467-0605
Practice Address - Fax:713-467-3771
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1052207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX060012329OtherRAILROAD MEDICARE
TX117615802Medicaid
TX74193943977014A001OtherCHAMPUS
TX870932OtherBLUE CROSS BLUE SHIELD
TX117615802Medicaid
TXC16769Medicare UPIN
TX870932OtherBLUE CROSS BLUE SHIELD