Basic Information
Provider Information | |||||||||
NPI: | 1427317148 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | POMERANTZ | ||||||||
FirstName: | HEATHER | ||||||||
MiddleName: | SCHEIBE | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | SCHEIBE | ||||||||
OtherFirstName: | HEATHER | ||||||||
OtherMiddleName: | MARIE | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | M.D. | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 3551 ROGER BROOKE DR | ||||||||
Address2: | INFECTIOUS DISEASE | ||||||||
City: | JBSA FT SAM HOUSTON | ||||||||
State: | TX | ||||||||
PostalCode: | 782344504 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2109165554 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 3551 ROGER BROOKE DR | ||||||||
Address2: | INFECTIOUS DISEASE | ||||||||
City: | JBSA FT SAM HOUSTON | ||||||||
State: | TX | ||||||||
PostalCode: | 782344504 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2109165554 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/15/2012 | ||||||||
LastUpdateDate: | 05/20/2016 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 27786 | NE | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 208D00000X | 27786 | NE | N |   | Allopathic & Osteopathic Physicians | General Practice |   |
No ID Information.