Healthcare Provider Details

I. General information

NPI: 1720249469
Provider Name (Legal Business Name): LIZA OPPER THALHEIMER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5585 WESLAYAN ST
HOUSTON TX
77005-1941
US

IV. Provider business mailing address

3820 NORTHDALE BLVD SUITE 201
DALLAS TX
75391-1230
US

V. Phone/Fax

Practice location:
  • Phone: 800-991-6117
  • Fax:
Mailing address:
  • Phone: 800-991-6117
  • Fax: 972-234-0813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License NumberR0334
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR0334
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: