Provider Demographics
NPI:1730173832
Name:HEARNE, STEVEN E (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:HEARNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 35629
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-0629
Mailing Address - Country:US
Mailing Address - Phone:214-424-2200
Mailing Address - Fax:214-231-2159
Practice Address - Street 1:2130 NE LOOP 410 STE 250
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-4662
Practice Address - Country:US
Practice Address - Phone:210-614-1234
Practice Address - Fax:210-614-0952
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG8173207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG1873OtherMED LICENSE
131336306Medicare ID - Type Unspecified
TXC16755Medicare UPIN