Dietze, Thomas Russell

Dietze, Thomas Russell is an individual health care provider with primary practice located at 5402 S Staples St Suite 100, Corpus Christi TX 78411-4656. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Dietze, Thomas Russell can be contacted via phone (361) 992-9400.

Contact Information

Primary practice address
5402 S Staples St Suite 100 Corpus Christi TX 78411-4656
Phone: (361) 992-9400
Fax: (361) 992-8295
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X H1574 Texas

Profile Details

NPI number 1417938713
LBN Legal business name Dietze, Thomas Russell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2005
Last updated Feb 28th, 2019 - about 7 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 1417938713 NPPES
Texas MEDICAID 129833303

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