Individual
LESLIE-ANNE JUAREZ DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 567-5225
(210) 358-4775
Mailing address
1624 W FLYNN LN, PHOENIX, AZ 85015-1432
(210) 787-8818
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
50595
AZ
208000000X
Pediatrics Physician
S5361
TX
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
S5361
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/22/2012
Last updated
04/09/2026
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