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Individual

DOUGLAS LEE DIESEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPO, LPO

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
255
TX
224P00000X
Prosthetist
255
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
531778
BCBS
TX
Enumeration date
04/10/2007
Last updated
02/25/2008
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