Individual
DANIEL R THEESFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3217 4TH ST, LONGVIEW, TX 75605-5145
(903) 753-7333
(903) 753-4849
Mailing address
3217 N 4TH ST, LONGVIEW, TX 75605-5145
(903) 753-7333
(903) 753-4849
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
J3712
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
J3712
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0046KA
BLUE CROSS ID
TX
Enumeration date
05/16/2006
Last updated
07/21/2022
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