Carl Theodore Heinrich IV
Student in an Organized Health Care Education/Training Program in San Antonio, TX. Individual provider (NPI-1).
NPI number1063083343
StatusActive
Last updated in NPPESJun 26, 2023
Details
- NPI
- 1063083343
- Entity type
- Individual (NPI-1)
- Name
- Carl Theodore Heinrich IV
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 7, 2021
- Certification date
- Jun 26, 2023
- Last updated
- Jun 26, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | BP10082391 | TX | Yes |
Practice location
7703 Floyd Curl DrSan Antonio, TX 78229-3900
Phone 210-567-7000
Mailing address
7703 Floyd Curl DrSan Antonio, TX 78229-3900
Phone 210-567-7000
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