Individual
DR. JENNIFER E. DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6620 MAIN ST, SUITE 1450, HOUSTON, TX 77030-2348
(713) 798-7500
(713) 798-6956
Mailing address
PO BOX 4775, HOUSTON, TX 77210-4775
(713) 798-1850
(713) 798-1702
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
L6358
TX
2080A0000X
Pediatric Adolescent Medicine Physician
L6358
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187205302
—
TX
Enumeration date
10/16/2006
Last updated
03/01/2011
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