Individual
THERESA MARIE VAIL
Active
Individual
THERESA MARIE VAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
L0672
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0392920-03
—
TX
01
—
731682660
TAX ID
TX
01
—
8AJ103
BCBS
TX
01
—
P00039903
RAILROAD MEDICARE
TX
Enumeration date
07/21/2005
Last updated
11/20/2014
Update your record
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