Autry, Heather Lynn

Autry, Heather Lynn is an individual health care provider with primary practice located at 1500 S Main St , Fort Worth TX 76104-4917. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Autry, Heather Lynn can be contacted via phone (817) 702-3431.

Contact Information

Primary practice address
1500 S Main St Fort Worth TX 76104-4917
Phone: (817) 702-3431
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 51402 Colorado
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 51402 Colorado
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X N953 Texas

Profile Details

NPI number 1093979395
LBN Legal business name Autry, Heather Lynn
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2008
Last updated Jun 4th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093979395 NPPES
Colorado MEDICAID 64771202
Colorado Other COA107693

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