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Contact Information

JOHN M HETTEMA, MD
8441 RIVERSIDE PARKWAY
CB1, SUITE 1100
BRYAN, TX77807
 Phone: 979-774-8200
 Fax: 979-776-6905
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for JOHN M HETTEMA · (Male)

NPI # 1639259088
Status Active
Credentials MD
Entity Individual
Enumeration date 10/17/2006
Last updated 10/23/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • TX License # S3188
  • VA License # 0101056225
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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