Provider Demographics
NPI:1528311297
Name:BOLLOCK, HEIDI A (CNS)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:A
Last Name:BOLLOCK
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Gender:F
Credentials:CNS
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Mailing Address - Street 1:7800 SHOAL CREEK BLVD
Mailing Address - Street 2:STE. 205-N
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1098
Mailing Address - Country:US
Mailing Address - Phone:512-206-4300
Mailing Address - Fax:512-206-4350
Practice Address - Street 1:2559 WESTERN TRAILS BLVD
Practice Address - Street 2:STE. 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1554
Practice Address - Country:US
Practice Address - Phone:512-899-2028
Practice Address - Fax:512-899-0311
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2022-02-10
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Provider Licenses
StateLicense IDTaxonomies
TX775404364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health