Provider Demographics
NPI:1942294715
Name:DRTIL, ALEXANDER F (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:F
Last Name:DRTIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 GESSNER RD
Mailing Address - Street 2:STE 585
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2527
Mailing Address - Country:US
Mailing Address - Phone:713-827-8710
Mailing Address - Fax:713-490-0844
Practice Address - Street 1:915 GESSNER RD
Practice Address - Street 2:STE 585
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2527
Practice Address - Country:US
Practice Address - Phone:713-827-8710
Practice Address - Fax:713-490-0844
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3812207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00165653OtherRAILROAD MEDICARE
TX136885402Medicaid
E45817Medicare UPIN
TX136885402Medicaid