| NPI | 1770184012 |
|---|---|
| Doing Business As | HEREOS HEALTHCARE PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | TRENT J FACKELMAN President/CEO 210-957-1419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2023-08-15 |