Provider Demographics
NPI:1659377893
Name:KREISLER, AARON L (MD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:L
Last Name:KREISLER
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 1:2379 GUS THOMASSON RD
Mailing Address - Street 2:STE 200
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150
Mailing Address - Country:US
Mailing Address - Phone:972-686-6400
Mailing Address - Fax:972-686-6391
Practice Address - Street 1:2379 GUS THOMASSON RD
Practice Address - Street 2:STE 200
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150
Practice Address - Country:US
Practice Address - Phone:972-686-6400
Practice Address - Fax:972-686-6391
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD33042080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1372757-02Medicaid
TX137275702Medicaid
TXE80295Medicare UPIN