| NPI | 1578005450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM A TISDALL Md 210-541-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2018-04-20 |