Individual
DR. LARRY MARTIN WIERTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7516 HOLLYTREE DR, TYLER, TX 75703-0928
(903) 561-1192
Mailing address
7516 HOLLYTREE DR, TYLER, TX 75703-0928
(903) 561-1192
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
F0822
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128562906
—
TX
01
—
P00404433
RAILOAD MEDICARE
TX
01
—
RAILROAD MEDICARE
827113008
TX
Enumeration date
09/01/2006
Last updated
01/13/2010
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