Organization
VASCULAR & GENERAL SURGERY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL LAWRENCE TILLY M.D. (PRESIDENT)
(830) 620-1191
Entity
Organization
Contact information
Practice address
191 N UNION AVE, NEW BRAUNFELS, TX 78130-4447
(830) 620-1191
(830) 620-1190
Mailing address
PO BOX 311130, NEW BRAUNFELS, TX 78131-1130
(830) 620-1191
(830) 620-1190
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020049264
MEDICARE RAILROAD
TX
05
—
143936601
—
TX
Enumeration date
11/01/2006
Last updated
10/27/2008
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