Provider Demographics
NPI:1992952659
Name:KING, HEATHER MERCEIR (MD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:MERCEIR
Last Name:KING
Suffix:
Gender:F
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:901 W 38TH ST STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1166
Practice Address - Country:US
Practice Address - Phone:512-421-4111
Practice Address - Fax:512-323-9185
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1844208600000X, 2086X0206X
FLME117166208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX342332901Medicaid
TX342332902Medicaid
TXP01932458OtherRAILROAD
TX385704YK4EMedicare PIN