Provider Demographics
NPI:1174566582
Name:HECHT, MAUDE BANCROFT (NP)
Entity type:Individual
Prefix:
First Name:MAUDE
Middle Name:BANCROFT
Last Name:HECHT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2306 N CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3220
Mailing Address - Country:US
Mailing Address - Phone:915-471-2589
Mailing Address - Fax:915-533-4902
Practice Address - Street 1:1205 N OREGON ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4023
Practice Address - Country:US
Practice Address - Phone:915-533-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP112763363L00000X
TX652027363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00180529OtherRAILROAD
8B2846Medicare ID - Type Unspecified
P00180529OtherRAILROAD
TX162867901Medicare ID - Type Unspecified