Wiertz, Larry Martin
Wiertz, Larry Martin is an sole proprietor health care provider with primary practice located at 7516 Hollytree Dr , Tyler TX 75703-0928. He recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as his primary health care specialty. Wiertz, Larry Martin can be contacted via phone (903) 561-1192.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism | 207RE0101X | F0822 | Texas |
Profile Details
| NPI number | 1104928019 |
|---|---|
| LBN Legal business name | Wiertz, Larry Martin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 1st, 2006 |
| Last updated | Jan 13th, 2010 - about 14 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 | 1104928019 | NPPES |
| Texas | Other | RAILROAD MEDICARE | 827113008 |
| Texas | Other | P00404433 | 827113008 |
| Texas | MEDICAID | 128562906 | 827113008 |
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