Dietze, John Brett
Dietze, John Brett is an individual health care provider with primary practice located at 2602 Saint Michael Dr Ste 302B , Texarkana TX 75503-5228. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Dietze, John Brett can be contacted via phone (903) 794-4196.Contact Information
Primary practice address
2602 Saint Michael Dr Ste 302B
Texarkana TX 75503-5228
Phone: (903) 794-4196
Fax: (903) 614-5169
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | K2152 | Texas |
Profile Details
| NPI number | 1588665319 |
|---|---|
| LBN Legal business name | Dietze, John Brett |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 2nd, 2005 |
| Last updated | Apr 28th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588665319 | NPPES |
| Texas | Other | 1G1885 | MEDICARE |
| Texas | Other | 141100101 | MEDICARE |
| Texas | Other | 18796000000 | MEDICARE |
| Texas | Other | 98601 | MEDICARE |
| Texas | Other | 98601 | MEDICARE |
| Texas | Other | 179117500 | MEDICARE |
| Texas | Other | 1871793307 | MEDICARE |
| Texas | Other | 8A0896 | MEDICARE |
| Texas | Other | 140006859 | MEDICARE |
| Texas | MEDICAID | 141100101 | MEDICARE |
| Texas | MEDICAID | 142238001 | MEDICARE |
| Texas | MEDICAID | 200023040A | MEDICARE |
| Texas | Other | 5575000001 | MEDICARE |
| Texas | Other | MDK2152 | MEDICARE |
| Texas | Other | 98601 | MEDICARE |
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