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Individual
WILLIAM E DIETZE
Active
Individual
WILLIAM E DIETZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
D4092
TX
207Y00000X
Otolaryngology Physician
Primary
D4092
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
089557503
—
TX
01
—
75-2616977-113
TRICARE
TX
Enumeration date
06/16/2005
Last updated
09/26/2018
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