Provider Demographics
NPI:1871600908
Name:ROLAND E. SIEGLER, M.D.,P.A.
Entity type:Organization
Organization Name:ROLAND E. SIEGLER, M.D.,P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:SIEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-468-1818
Mailing Address - Street 1:3215 OMEGA DRIVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2006
Mailing Address - Country:US
Mailing Address - Phone:817-468-1818
Mailing Address - Fax:817-468-4775
Practice Address - Street 1:3215 OMEGA DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2006
Practice Address - Country:US
Practice Address - Phone:817-468-1818
Practice Address - Fax:817-468-4775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9997174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty