| Organization Name: | HERITAGE INTER-MED, PLLC |
| NPI Number: | 1013136787 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CECIL C BAILEY (OWNER) |
| Mailing Address: | 200 Bryan Pl Cedar Hill |
| State: | TX US |
| Postal Code: | 751041768 |
| Phone Number: | 9722990003 |
| Fax Number: | 9722990004 |
| NPI Enumeration Date: | 04/24/2007 |
| NPI Last Update Date: | 04/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | L0008 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |