Healthcare Provider Details

I. General information

NPI: 1083825400
Provider Name (Legal Business Name): TIMOTHY JOHN HEPLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 04/11/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 MEDICAL CENTER ROAD
FT. CAVAZOS TX
76544
US

IV. Provider business mailing address

590 MEDICAL CENTER ROAD
FT. CAVAZOS TX
76544
US

V. Phone/Fax

Practice location:
  • Phone: 254-288-8197
  • Fax:
Mailing address:
  • Phone: 254-288-8197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number50238
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: