Organization
WILLIAM A. TISDALL, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM ALEC TISDALL M.D. (PRESIDENT)
(210) 541-0700
Entity
Organization
Contact information
Practice address
1919 ROGERS RD, SUITE 104, SAN ANTONIO, TX 78251-4614
(210) 541-0700
(210) 514-6868
Mailing address
1919 ROGERS RD, SUITE 204, SAN ANTONIO, TX 78251-4614
(210) 541-0700
(210) 514-6868
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039TQ
BLUE CROSS
TX
05
—
217091201
—
TX
Enumeration date
06/04/2010
Last updated
04/05/2018
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