Basic Information
| Provider Information | |||||||||
| NPI: | 1053315598 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HEATH | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2102 TREASURE HILLS BLVD # 3.14406 | ||||||||
| Address2: | |||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785508736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9562961437 | ||||||||
| FaxNumber: | 9562966842 | ||||||||
| Practice Location | |||||||||
| Address1: | 1330 E 6TH ST STE 105 | ||||||||
| Address2: | |||||||||
| City: | WESLACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785966608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9562967710 | ||||||||
| FaxNumber: | 9562967705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2005 | ||||||||
| LastUpdateDate: | 12/10/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | H9984 | TX | N | Allopathic & Osteopathic Physicians | Hospitalist | 207P00000X | H9984 | TX | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | H9984 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 035070429 | 05 | TX | MEDICAID | 035070430 | 05 | TX | MEDICAID | 035070439 | 05 | TX | MEDICAID | TXB130797 | 05 | TX | MEDICAID | P00828165 | 01 | TX | RAILROAD MEDICARE | OTHER | 035070440 | 01 | TX | TMHP-CSHCN | OTHER | 8CR923 | 01 | TX | BCBS | OTHER | 8BQ004 | 01 | TX | BCBS | OTHER |