Dale Heathcock

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Practice address

107 W Way St
Suite 19-20
Lake Jackson, TX 77566-5219

Phone

(979) 266-9497

Fax

(979) 266-9507

NPI assigned

Jan 27, 2017

Last updated

Jan 27, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1485475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485475200000",
    "number": "1902343056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 PLATINUM CHASE DR",
            "city": "ROSHARON",
            "state": "TX",
            "postal_code": "775833275",
            "telephone_number": "281-635-7458",
            "fax_number": "281-778-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W WAY ST",
            "address_2": "SUITE 19-20",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665219",
            "telephone_number": "979-266-9497",
            "fax_number": "979-266-9507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATHCOCK",
        "first_name": "DALE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-27",
        "last_updated": "2017-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Harnden, MS,PT
• Harrison Dermatology of Lake Jackson PLLC
• Robert G Haws, O.D.
• Healthy Growth Mindset, LLC
• Stacie D Heath, PHARMD
• Heavenly Touch Hospice Care, LLC
• Jennifer Wilson Hedrick, LPC
• Nathalie Heimeyer
• Help Home Primary Care, PLLC
• Helping Hands and Hearts Hospice

• Sleep Disorder Diagnostic Clinic/Center in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Sleep Disorder Diagnostic Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.