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Organization
MULTI-SPECIALTY DIAGNOSTIC CENTER REBECCA A PREISS GEN PTR
Active
Organization
MULTI-SPECIALTY DIAGNOSTIC CENTER REBECCA A PREISS GEN PTR
Active
Other names
Multi-Specialty Diagnostic Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME D KIZZART MD (OWNER PHYSICIAN)
(830) 815-1202
Entity
Organization
Contact information
Practice address
6511 US HIGHWAY 181 N, SUITE 1, FLORESVILLE, TX 78114-6281
(830) 815-1202
(830) 815-1205
Mailing address
6511 US HIGHWAY 181 N, SUITE 1, FLORESVILLE, TX 78114-6281
(830) 815-1202
(830) 815-1205
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
H3823
TX
207R00000X
Internal Medicine Physician
Primary
H3823
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
M6603
TX
207RP1001X
Pulmonary Disease Physician
M6603
TX
207RS0012X
Sleep Medicine (Internal Medicine) Physician
M6603
TX
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
H3823
TX
208M00000X
Hospitalist Physician
H3823
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95RT
BCBS
TX
Enumeration date
09/15/2008
Last updated
03/26/2010
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