Provider Demographics
NPI:1851756977
Name:AARON L. KREISLER, M.D. P.A.
Entity Type:Organization
Organization Name:AARON L. KREISLER, M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:KREISLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-324-4221
Mailing Address - Street 1:1151 N BUCKNER BLVD # PB1
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3426
Mailing Address - Country:US
Mailing Address - Phone:214-324-4221
Mailing Address - Fax:214-324-3805
Practice Address - Street 1:1151 N BUCKNER BLVD # PB1
Practice Address - Street 2:SUITE 203
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3426
Practice Address - Country:US
Practice Address - Phone:214-324-4221
Practice Address - Fax:214-324-3805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3304208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137275702Medicaid
TX137275708Medicaid