Provider Demographics
NPI:1730817933
Name:ADAMSON, HEATHER DANIELLE (OD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:DANIELLE
Last Name:ADAMSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 S PADRE ISLAND DR STE 119B
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5342
Mailing Address - Country:US
Mailing Address - Phone:361-993-7778
Mailing Address - Fax:
Practice Address - Street 1:5425 S PADRE ISLAND DR STE 119B
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5342
Practice Address - Country:US
Practice Address - Phone:361-993-7778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10617T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist