Basic Information
Provider Information
NPI: 1528013927
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HECK
FirstName: MARGARET
MiddleName: F
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 26666
Address2: PHS PROVIDER ENROLLMENT
City: ALBUQUERQUE
State: NM
PostalCode: 871256666
CountryCode: US
TelephoneNumber: 5059236770
FaxNumber: 5059235354
Practice Location
Address1: 5400 GIBSON BLVD SE
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871084729
CountryCode: US
TelephoneNumber: 9048051300
FaxNumber: 9048051302
Other Information
ProviderEnumerationDate: 05/23/2006
LastUpdateDate: 09/19/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X2000-207NMY Allopathic & Osteopathic PhysiciansEmergency Medicine 

ID Information
IDTypeStateIssuerDescription
0788034105NM MEDICAID
A01701NMTRICAREOTHER


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