Provider Demographics
NPI:1679640825
Name:HIEBER, JAMES PATRICK (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PATRICK
Last Name:HIEBER
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 1:8355 WALNUT HILL LANE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4219
Mailing Address - Country:US
Mailing Address - Phone:214-368-3659
Mailing Address - Fax:214-691-8801
Practice Address - Street 1:8355 WALNUT HILL LANE
Practice Address - Street 2:SUITE 205
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4219
Practice Address - Country:US
Practice Address - Phone:214-368-3659
Practice Address - Fax:214-691-8801
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6809208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
F58831Medicare UPIN