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Individual

DR. THOMAS LUKE HEIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4364 HERITAGE TRACE PKWY # 112A, FORT WORTH, TX 76244-9106
(817) 576-0884
Mailing address
2817 DYER ST, DALLAS, TX 75205-1905
(704) 377-5772

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Q0453
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
Q0453
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2280704
MEDICARE UPIN
TX
05
89126P7
TX
01
AA7485A309
MEDICARE UPIN
TX
05
N00453
TX
01
NC1837A
MEDICARE UPIN
TX
Enumeration date
04/11/2006
Last updated
02/17/2020
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