Dietz, Maryetta

Dietz, Maryetta is an individual health care provider with primary practice located at 1600 W 38Th St Suite 308, Austin TX 78731-6400. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Dietz, Maryetta can be contacted via phone (512) 324-3540.

Contact Information

Primary practice address
1600 W 38Th St Suite 308 Austin TX 78731-6400
Phone: (512) 324-3540
Fax: (512) 324-3541
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 760224 Texas

Profile Details

NPI number 1316957582
LBN Legal business name Dietz, Maryetta
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Jan 3rd, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316957582 NPPES
Texas MEDICAID 204269903
Texas Other 819N67
Texas MEDICAID 204269904

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