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General NPI Number Information
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NPI Number | 1245310168
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Entity Type | Individual
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Provider Name | GERALD PAUL HEISLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 9105 N WAYSIDE DR
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City | HOUSTON
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State | TX
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Zip | 77028-1030
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Country | US
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Telephone | 713-633-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 205 E UNIVERSITY AVE SUITE 200
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City | GEORGETOWN
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State | TX
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Zip | 78626-6814
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Country | US
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Telephone | 877-800-5722
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H4396
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License Number State | TX
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