Provider Demographics
NPI:1457678336
Name:OSTLER, HEIDI MARIE (MD)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:MARIE
Last Name:OSTLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:MARIE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6210 E US HWY 290
Mailing Address - Street 2:SUITE 420-CREDENTIALING
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1098
Mailing Address - Country:US
Mailing Address - Phone:512-338-3826
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:3420 FM 967 STE B100
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-3113
Practice Address - Country:US
Practice Address - Phone:512-295-1608
Practice Address - Fax:512-406-7325
Is Sole Proprietor?:No
Enumeration Date:2010-04-30
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR0966207Q00000X
CODR0050702207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX368025802Medicaid
TX368025801Medicaid
TX368025802Medicaid
TX557736YKXVMedicare PIN