Individual provider Active NPI

Heather Warren, PA-C

  • Physician Assistant
  • Bryan, TX
National Provider Identifier
1295154516
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10148 Issued in TX
Practice address
2801 Franciscan Dr
Bryan, TX 77802-2544
Phone
(979) 776-2537
Fax
(979) 776-2526
NPI assigned
Apr 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1789 NE
Physician Assistant 363A00000X PA10148 TX Primary

Addresses

Primary practice location

2801 Franciscan Dr
Bryan, TX 77802-2544

Mailing address

2800 S Texas Ave Ste 102
Bryan, TX 77802-5361
Phone (936) 266-3513

Other practice location 1

2401 S 31st St
Temple, TX 76508-0001
Phone (254) 724-2111

Other practice location 2

1604 Rock Prairie Rd
College Station, TX 77845-8343
Phone (979) 680-5474

Other identifiers 1

IdentifierTypeStateIssuer
353388702MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151231000397 TX Practitioner - Physician Assistant 4789807389 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10148TXMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: hwarren80702@direct.sw.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1295154516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 S TEXAS AVE STE 102",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025361",
            "telephone_number": "936-266-3513",
            "fax_number": "713-852-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 FRANCISCAN DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022544",
            "telephone_number": "979-776-2537",
            "fax_number": "979-776-2526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 S 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-724-2111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1604 Rock Prairie Rd",
            "address_purpose": "LOCATION",
            "city": "College Station",
            "state": "TX",
            "postal_code": "778458343",
            "country_code": "US",
            "telephone_number": "979-680-5474",
            "fax_number": "979-680-5487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARREN",
        "first_name": "HEATHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1789",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "353388702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.