Individual
DR. TIMOTHY WAYNE DZIUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2130 NE LOOP 410 STE 100, SAN ANTONIO, TX 78217-4660
(210) 656-7177
(210) 656-3687
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-0813
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
H8017
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136082812
—
TX
05
—
136082813
—
TX
05
—
136082814
—
TX
01
—
8B9047
BLUE CROSS BLUE SHIELD
TX
01
—
8R1430
BCBS OF TX
TX
01
—
920006455
RAILROAD MEDICARE
TX
Enumeration date
06/04/2006
Last updated
04/06/2016
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