Provider Demographics
NPI: | 1174573042 |
---|---|
Name: | HEKIER, RON JOSEPH (MD PA) |
Entity type: | Individual |
Prefix: | DR |
First Name: | RON |
Middle Name: | JOSEPH |
Last Name: | HEKIER |
Suffix: | |
Gender: | M |
Credentials: | MD PA |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 2717 SUMMERHILL RD |
Mailing Address - Street 2: | |
Mailing Address - City: | TEXARKANA |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75503 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 903-794-0022 |
Mailing Address - Fax: | 903-794-0023 |
Practice Address - Street 1: | 2717 SUMMERHILL RD |
Practice Address - Street 2: | |
Practice Address - City: | TEXARKANA |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75503 |
Practice Address - Country: | US |
Practice Address - Phone: | 903-794-0022 |
Practice Address - Fax: | 903-794-0023 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2006-05-11 |
Last Update Date: | 2012-02-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | L6062 | 208600000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 208600000X | Allopathic & Osteopathic Physicians | Surgery |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
AR | 149566001 | Medicaid | |
AR | 82312 | Other | AR BCBS |
TX | 0061MB | Other | TX BCBS |
TX | 157029302 | Medicaid | |
TX | 8AJ746 | Other | BLUE CROSS BLUE SHIELD |
TX | P00258900 | Medicare PIN | |
TX | 157029302 | Medicaid | |
H79391 | Medicare UPIN |