Provider Demographics
NPI:1881579639
Name:HEAP, AMBER JEAN (MS, RDN, LD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:JEAN
Last Name:HEAP
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6007 N IH 35 APT 257
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1278
Mailing Address - Country:US
Mailing Address - Phone:657-203-1733
Mailing Address - Fax:
Practice Address - Street 1:6007 N IH 35 APT 257
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1278
Practice Address - Country:US
Practice Address - Phone:657-203-1733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86404106133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered