Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | L7945 | TX |
Y | 213ES0000X | Sports Medicine | L7945 | TX |
NPI | 1225002819 |
---|---|
Provider Name | Dr. Catherine M Fieseler |
First Address | Dallas, TX 75284-6098 |
Second Address | Tyler, TX 75701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 13/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
123908 | CHIPS (01) | TX |
164217501 | (05) | TX |
164217502 | (05) | TX |
4343058 | AETNA (01) | TX |
750818167007 | TRICARE (01) | TX |
752616977021 | TRICARE CHAMPUS (01) | TX |
8DH351 | BCBS (01) | TX |
F65189 | (02) | |
FE08G0399 | BCBS (01) | TX |
P00194174 | MEDICARE RAILROAD (01) | TX |
P01105225 | RAIL ROAD (01) | TX |