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General NPI Number Information
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NPI Number | 1326001256
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Entity Type | Individual
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Provider Name | THOMAS LUKE HEIL MD
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Gender | Male
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 4364 HERITAGE TRACE PKWY # 112A
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City | FORT WORTH
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State | TX
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Zip | 76244-9106
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Country | US
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Telephone | 817-576-0884
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Fax |
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Provider Business Mailing Address
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Address Line | 2817 DYER ST
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City | DALLAS
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State | TX
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Zip | 75205-1905
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Country | US
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Telephone | 704-377-5772
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | Q0453
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | Q0453
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License Number State | TX
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