Most Relevant Information
Provider Data
| NPI Number: | 1003484072 |
| Provider Name: | HEATHER TISDALE |
| Entity Type: | Individual |
| Taxonomy Code: | 207L00000X |
| Specialty: | Anesthesiology |
| License Number: | BP10077045 |
Most Important Dates
| Enumeration Date: | 06/15/2021 |
| Last Updated: | 06/15/2021 |
Provider Practice Location
301 UNIVERSITY BLVD
GALVESTON
TX
775555302
Practice Location Phone/Fax
| Phone: | 4097722222 |
| Fax: |
Provider Mailing Location
301 UNIVERSITY BLVD
GALVESTON
TX
775555302
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |