Pietsch, Darrell R
Pietsch, Darrell R is an individual health care provider with primary practice located at 6600 Fish Pond Rd Ste 202A , Waco TX 76710-2582. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Pietsch, Darrell R can be contacted via phone (254) 732-6789.Contact Information
Primary practice address
6600 Fish Pond Rd Ste 202A
Waco TX 76710-2582
Phone: (254) 732-6789
Fax: (254) 732-6790
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | K7867 | Texas |
Profile Details
| NPI number | 1780689992 |
|---|---|
| LBN Legal business name | Pietsch, Darrell R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2005 |
| Last updated | Jan 8th, 2010 - about 16 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 | 1780689992 | NPPES |
| Texas | Other | 8BZ212 | BCBS |
| Texas | MEDICAID | 103631105 | BCBS |
| Texas | Other | 8L10057 | BCBS |
| Texas | MEDICAID | 103631103 | BCBS |
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