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Individual

ALISA THAMWIWAT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1604 HOSPITAL PKWY STE 301, BEDFORD, TX 76022
(817) 684-9970
(844) 290-4362
Mailing address
1604 HOSPITAL PKWY STE 301, BEDFORD, TX 76022-6931
(817) 684-9970
(844) 290-4362

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10041540
TX
207RC0000X
Cardiovascular Disease Physician
P9751
TX
207RI0011X
Interventional Cardiology Physician
Primary
P9751
TX
207UN0901X
Nuclear Cardiology Physician
P9751
TX

Other

Enumeration date
06/15/2011
Last updated
05/19/2023
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