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General NPI Number Information
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NPI Number | 1598085243
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Entity Type | Organization
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Legal Business Name | WILLIAM A. TISDALL, M.D., P.A.
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Dates
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Enumeration Date | 06/04/2010
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Last Update Date | 04/05/2018
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Provider Practice Location Address
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Address Line | 1919 ROGERS RD SUITE 104
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City | SAN ANTONIO
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State | TX
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Zip | 78251-4614
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Country | US
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Telephone | 210-541-0700
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Fax | 210-514-6868
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Provider Business Mailing Address
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Address Line | 1919 ROGERS RD SUITE 204
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City | SAN ANTONIO
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State | TX
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Zip | 78251-4614
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Country | US
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Telephone | 210-541-0700
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Fax | 210-514-6868
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM ALEC TISDALL
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Credential | M.D.
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Telephone | 210-541-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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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 |
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License Number State |
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