Healthcare Provider Details

I. General information

NPI: 1548245798
Provider Name (Legal Business Name): EROL HUSEYIN OZDIL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 06/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4316 JAMES CASEY ST BUILDING A
AUSTIN TX
78745-1157
US

IV. Provider business mailing address

PO BOX 1509
SAN ANTONIO TX
78295-1509
US

V. Phone/Fax

Practice location:
  • Phone: 512-623-5300
  • Fax: 512-623-5399
Mailing address:
  • Phone: 512-623-5300
  • Fax: 512-623-5399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberJ3866
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: