Provider Demographics
NPI:1912199563
Name:TRISTAN, SIGRID BIRGITTA (MD)
Entity Type:Individual
Prefix:DR
First Name:SIGRID
Middle Name:BIRGITTA
Last Name:TRISTAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SIGRID
Other - Middle Name:BIRGITTA
Other - Last Name:MELANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1912 SPEEDWAY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78712-1235
Mailing Address - Country:US
Mailing Address - Phone:512-324-8960
Mailing Address - Fax:
Practice Address - Street 1:601 E 15TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1930
Practice Address - Country:US
Practice Address - Phone:512-324-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.12075207V00000X
NY244783207V00000X
TXQ4866207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX356696001Medicaid
TX476659YMGJMedicare PIN